[PP.LB02.09] UTILISING PULSE WAVE VELOCITY IN ASSESSING ARTERIAL STIFFNESS IN PATIENTS WITH MILD-TO-MODERATE RENAL IMPAIRMENT

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Abstract

Objective:

We aimed to study arterial stiffness using pulse wave velocity (PWV) among patients with chronic kidney disease stage 2 to 4 and normal renal function.

Design and method:

Patients with confirmed chronic kidney disease stage 2 to 4 were recruited from various clinics in the Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Malaysia from 1st August 2015 until 31th January 2016. Sociodemographic and anthropometric indices were recorded at recruitment. Each patient underwent a carotid-femoral (aortic) PWV measurement to determine the arterial stiffness.

Results:

We studied a cohort of 174 patients: 87 patients with chronic kidney disease stage 2–4 and 87 control patients. The mean age was 47 ± 5.4 years. CKD patients had a higher mean PWV (7.8 ± 1.7) than healthy controls (5.6 ± 1.0) (p < 0.001, 95% CI −2.59,−1.77). There is significant difference of mean PWV between control (5.6 m/s ± 1.0) and CKD stage 2 (7.6 ± 1.5) (p < 0.001, 95% CI −2.40,−1.49). Our results showed a stepwise increase in PWV from control subjects, CKD stage 2 through stage 4 (p < 0.001). The mean difference of PWV between CKD stage 2 (7.6 m/s, ± 1.5) and stage 4 (9.0 m/s, ± 0.8) was 1.43 (p < 0.001, 95% CI −2.50, −0.35). There was significant difference of mean PWV between diabetes mellitus (DM) (8.2 m/s ± 1.8) and non-DM (7.3 m/s ± 1.3) patients with CKD stage 2–4 (p = 0.022, 95% CI −1.50,−0.12). There was a significant positive asssociation between DM and PWV (β = 0.81, r2 = 0.06, p = 0.022). However, no significant association was found on the multivariate analysis beween DM and PWV. Mutiple linear regression analysis showed only age (β = 0.078, p = 0.014), mean arterial pressure (MAP) (β = 0.031,p = 0.007) and diuretics usage as the combination antihypertensive medication (β = 0.839,p = 0.018) were independently associated with PWV (r2 = 0.249, p < 0.001).

Conclusions:

This study shows that arterial stiffness as assessed by PWV occurs early in CKD patient and increased arterial stiffness occurs in parallel with decline of glomerular filtration rate in patients with mild-to-moderate CKD of younger age population.

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