Abstract: FR-OR06
Arterial Stiffness and AKI in the Atherosclerosis Risk in Communities (ARIC) Study
Session Information
- AKI Prediction and Assessment: Traditional and Novel Tools
November 03, 2023 | Location: Room 118, Pennsylvania Convention Center
Abstract Time: 05:15 PM - 05:24 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Oh, Ester, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Surapaneni, Aditya L., New York University Grossman School of Medicine, New York, New York, United States
- Kendrick, Jessica B., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Coresh, Josef, Johns Hopkins University, Baltimore, Maryland, United States
- Matsushita, Kunihiro, Johns Hopkins University, Baltimore, Maryland, United States
- Grams, Morgan, New York University Grossman School of Medicine, New York, New York, United States
- Nowak, Kristen L., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Jovanovich, Anna, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
Background
Acute kidney injury (AKI) is associated with prolonged hospitalization and increased in-hospital mortality risk. However, the prediction of incident AKI is inaccurate and additional predictors of AKI are strongly needed. Arterial stiffness, as measured by carotid-femoral pulse wave velocity (cfPWV), is associated with kidney function decline and may serve as a plausible predictor of AKI. We hypothesized a higher cfPWV at baseline would be independently associated with AKI risk in community-dwelling older adults who participated in the Atherosclerosis Risk in Communities (ARIC) study.
Methods
We included adults with available PWV measures (i.e., cfPWV [primary predictor], heart-femoral PWV [hfPWV], heart-carotid PWV [hcPWV], heart-ankle PWV [haPWV], and brachial-ankle PWV [baPWV], femoral-ankle PWV [faPWV]). Cox proportional hazard models were used to examine the association between PWV measures and time to AKI. Given its J-shaped relation with AKI, PWV was modeled as a categorical variable in quartiles (Q), with Q2 serving as the reference category.
Results
A total of 4,245 participants (44% male; 77% white; mean±SD age 75±5 years; cfPWV 11.9±3.9 m/s) were included. There appeared to be a J-shaped association between cfPWV and AKI risk (Q1, hazard ratio 1.15 [95% confidence interval 0.90-1.46]; Q4, 1.38 [1.08-1.77] vs. Q2) after fully adjusting for demographics, CVD risk factors, and markers for kidney function and peripheral artery disease (Figure).
Conclusion
A higher arterial stiffness, measured by cfPWV, is an independent predictor of AKI in community-dwelling older adults.
Association between cfPWV and AKI risk. M1: age, sex, race; M2: M1 + cardiovascular risk factors (smoking, diabetes, CVD, hypertension, SBP, DBP, BMI, total and HDL cholesterol); M3: M2 + kidney function markers (eGFR, urinary ACR); M4: M3 + peripheral artery disease marker (ankle-brachial index).
Funding
- NIDDK Support