ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-OR06

Arterial Stiffness and AKI in the Atherosclerosis Risk in Communities (ARIC) Study

Session Information

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