Abstract: PO2299
Arterial Stiffness Is Associated with the Progression of Abdominal Aortic Calcification in CKD: From the KNOW-CKD Study
Session Information
- CKD: Drugs, Diet, and Other Determinants
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Kim, Sang-Eun, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Jongno-gu, Korea (the Republic of)
- Jung, Sunghoon, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Jongno-gu, Korea (the Republic of)
- Lee, Kyu-Beck, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Jongno-gu, Korea (the Republic of)
- Kim, Hyang, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Jongno-gu, Korea (the Republic of)
- Hyun, Young Youl, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Jongno-gu, Korea (the Republic of)
Background
Cardiovascular disease is an important cause of death in patients with chronic kidney disease. Vascular calcification is a hallmark of chronic kidney disease and an important risk factor for cardiovascular morbidity and mortality. Therefore, it is important to identify the factors that exacerbate vascular calcification for the prevention of cardiovascular complications in patients with chronic kidney disease. Although the relationship between arterial stiffness and vascular calcification is well-known, the association between the preexisting arterial stiffness and the progression of vascular calcification is not known. In this study, we analyzed the relationship between arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) and the progression of abdominal aortic calcification (AAC) evaluated by abdominal aortic calcium score (AACS).
Methods
We selected patients who underwent lumbar X-ray and AACS measurements at the start of the study and 4 years later from the KNOW-CKD cohort. After excluding 26 patients with previous peripheral vascular disease, we analyzed 906 patients. Participants were divided into 3 groups according to their baPWV. The progression of abdominal aortic calcification was defined as an increase in AACS after 4 years compared to the baseline.
Results
After 4 years, a total of 312 patients (34.4%) developed the progression of AAC. The progression of AAC was more frequent with higher baPWV. The incidence rates of AAC progression were 17.6%, 33.0% and 52.5% for T1 through T3 of baPWV (P<0.001). In multivariate logistic regression analysis adjusted for various cardiovascular risk factors, the odds ratio for the progression of AAC compared to T1 were 1.54 (95%CI 1.02-2.34) and 2.16 (95%CI 1.34-3.46) for T2 and T3 of baPWV.
Conclusion
Arterial stiffness is a risk factor for the progression of AAC in chronic kidney disease. This suggests that interventions that can improve arterial stiffness might be helpful in reducing cardiovascular complications in patients with chronic kidney disease.
Table. Multivariate-adjusted ORs (95% CI) for AAC progression according to baPWV
| baPWV tertile | Model 1 | Model 2 | Model 3 | |||
| OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | |
| 1 | reference | reference | reference | |||
| 2 | 2.31 (1.57-3.37) | <0.001 | 1.54 (1.02-2.34) | 0.041 | 1.54 (1.02-2.34) | 0.042 |
| 3 | 5.17 (3.56-7.50) | <0.001 | 2.11 (1.32-3.37) | 0.005 | 2.16 (1.34-3.46) | <0.001 |
| Model 1: Unadjusted Model 2: Adjusted for age, sex, systolic blood pressure, waist-hip ratio, diabetes, angiotensin-converting enzyme inhibitor or aldosterone receptor antagonist, statin, vitamin D analogue, calcium-base phosphate binder, eGFR, LDL cholesterol, HDL cholesterol, hsCRP, urine protein to creatinine ratio, calcium, phosphorus, vitamin D, and parathyroid hormone Model 3: Adjusted for model 2 + current smoking status, alcohol intake, physical activity and baseline AAC score OR, odds ratio; AAC, abdominal aortic calcification; CI, confidence interval; eGFR, estimated glomerular filtration rate; LDL, low-density lipoprotein; HDL, high-density lipoprotein; hsCRP, high-sensitivity C-reactive protein | ||||||