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Abstract: SA-OR016

Arterial Stiffness Independently Predicts AKI in SPRINT

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Bispham, Nina, University of Colorado, Aurora, Colorado, United States
  • Nowak, Kristen L., University of Colorado Denver: Anschutz Medical Campus, Aurora, Colorado, United States
  • You, Zhiying, UC Denver, Aurora, Colorado, United States
  • Supiano, Mark A., University of Utah Geriatrics Division, Salt Lake, Utah, United States
  • Chonchol, Michel, University of Colorado, Aurora, Colorado, United States
  • Jovanovich, Anna Jeanette, Denver VA / University of Colorado, Denver, Colorado, United States
Background

Arterial stiffness is associated with increased risk for kidney function decline and cardiovascular disease in both healthy and chronic kidney disease populations, independent of blood pressure. An episode of acute kidney injury (AKI) is also associated with increased risk for kidney disease progression and cardiovascular disease. However, it is unclear if arterial stiffness predicts AKI. We hypothesized that higher arterial stiffness at baseline was independently associated with time to incident AKI among participants in the Systolic Blood Pressure Intervention Trial (SPRINT).

Methods

Arterial stiffness was measured as carotid to femoral pulse-wave velocity (CFPWV) in 613 older adults at high risk for cardiovascular events who participated in an ancillary study of SPRINT. Cox proportional hazards analysis was used to examine the association between baseline CFPWV and time to incident AKI.

Results

Mean±sd age was 72±9 years and 40% (n=244) of participants were female. Mean±sd baseline CFPWV was 10.8±2.7 m/s in the whole cohort. In the 593 individuals who did not have an AKI event, baseline CFPWV was 10.7±2.7 m/s. In the 20 participants who had incident AKI, baseline CFPWV was 12.5±2.7 m/s (p<0.01) and median (IQR) time to AKI was 453 (289-724) days. After adjusting for demographics, randomization group, comorbidities, smoking, number of antihypertensive medications, baseline estimated glomerular filtration rate, urinary albumin to creatine ratio, and systolic blood pressure, risk of an AKI event was 32% higher for each m/s increase in baseline CFPWV (HR: 1.32, 95% CI: 1.13-1.53).

Conclusion

Greater large-elastic artery stiffness is a strong independent predictor of incident AKI in older adults at high risk for cardiovascular events. Clinical assessment of arterial stiffness may represent a useful tool to predict AKI, as well as a potential therapeutic target.

Funding

  • NIDDK Support