The decline of renal function aggravates arterial stiffness: a large-scale cross-sectional and longitudinal study

PurposeMany studies investigated the one-single-direction relationship between arterial stiffness and chronic kidney dysfunction, particularly in patients with end-stage renal disease. The bidirectional relevance between kidney function decline and arterial stiffness in general population remains unknown. This study aimed to address the temporary relationship between arterial stiffness and renal function. Materials and MethodsThis large-scale observational study comprised one cross-sectional and one longitudinal population sample totalling 67,060 individuals aged over 18 years with brachial-ankle pulse wave velocity (baPWV) and estimated glomerular filtration rate (eGFR) measurements available. Associations with potential risk conditions were analysed using multiple regression analyses. Cox proportional model was used to investigate the association of arterial stiffness and incident chronic kidney disease (CKD). Cross-lagged path analysis was further conducted to analyze the temporal relationship between baPWV and eGFR. ResultsMultiple regression analyses showed that baPWV was inversely associated with eGFR. Compared with the lower baPWV tertile group, higher baPWV was a predictor of CKD risk, with increased HRs for three baPWV tertile groups [HR=2.17 (1.26-3.76), P for trend <0.05]. Accordingly, lower eGFR was significantly associated with higher arterial stiffness risk, even after full-adjusted [HR=1.21 (1.02-1.44), P for trend <0.05]. In the path analysis, the coefficient of the association between baseline baPWV and follow-up eGFR was lower than the effect of baseline eGFR for follow-up baPWV (-0.063 Vs. -0.077, P <0.001). ConclusionsDecrease of eGFR appeared to aggravate arterial stiffness, which unravelling a new understanding of the role kidney dysfunction played in arterial stiffening.