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Kidney Week

Abstract: FR-PO0347

Does Diabetes Exacerbate Arterial Stiffness in CKD?

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Giourdas, Ashley Danielle, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Chen, Stone, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Campos, Monique Opuszcka, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Hiemstra, Thomas, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, England, United Kingdom
  • Zehnder, Daniel, Cambridge Clinical Trials Unit, Cambridge, England, United Kingdom
  • Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States
Background

Arterial stiffness is a major contributor to cardiovascular disease and is common in both chronic kidney disease (CKD) and diabetes (DM). It is unclear if the severity of arterial stiffness is exacerbated in individuals who have comorbid CKD and diabetes. We hypothesized that individuals who have CKD with DM (CKD+DM) would have greater arterial stiffness compared those who have CKD without DM (CKD).

Methods

We performed a cross-sectional study using baseline data from the Cardiopulmonary Exercise Testing in Renal Failure after Kidney Transplantation (CAPER) study. CAPER recruited participants with advanced CKD stages 5 and 5D awaiting transplant. Participants were stratified into two groups: CKD+DM (n=21) or CKD (n=62). Arterial stiffness was assessed by pulse wave velocity and augmentation index at 75 bpm. Group comparisons were performed using a t-test or Mann-Whitney test. Associations were assessed using multiple linear regression modeling.

Results

The CKD+DM group was significantly older than the CKD group (CKD+DM = 58.6±9.7 years vs CKD = 45.1±14.5 years; p<0.0001). There was no difference between groups for sex, race, body mass index, mean arterial pressure, or dialysis duration (all p>0.05). Significantly, pulse wave velocity was higher in the CKD+DM group versus CKD group (10.1 (IQR 8.9 - 13.2) m/s vs 7.8 (IQR 6.6 - 9.1) m/s respectively; p<0.0001) when measured by pulse wave velocity, but not when measured by augmentation index at 75 bpm (28.5±10.8 % vs 23.1±11.9 %; p=0.07). Pulse wave velocity was found to have a significant association with age (β=0.10, <0.0001) and mean arterial pressure (β=0.06, p<0.01), but not with sex (ref = female, β=0.15, p=0.79). After adjusting for the covariates age, mean arterial pressure, and sex the association between pulse wave velocity and having CKD+DM remained significant (β=2.01, p<0.01).

Conclusion

The coexistence of DM and CKD compounds arterial stiffness when measured directly by pulse wave velocity, but not indirectly by augmentation index at 75bpm. These results suggest that pulse wave velocity is more sensitive to arterial changes in individuals with CKD+DM and that these changes are located centrally at the aorta rather than in the peripheral arteries.

Funding

  • Private Foundation Support

Digital Object Identifier (DOI)