Association between renal function and arterial stiffness among women with systemic lupus erythematosus or antiphospholipid syndrome.

Abstract

Background: Patients diagnosed with systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APS) carry a higher risk of atherosclerosis and subsequent major adverse cardiac events; however, the mechanisms of such complications are still not fully understood. Although patients with SLE or APS are also known to have an increased risk of renal function impairment, there are few data on the correlation of augmentation index normalized to 75 beats per minute (AI@75) or pulse wave velocity (PWV) reflecting arterial remodeling, with laboratory tests indicative of renal function in women diagnosed with SLE or APS.

Methods: This was a prospective, cross-sectional study that enrolled women with a diagnosis of SLE and/or APS. All patients underwent measurement of carotid-femoral PWV (SphygmoCor XCEL, AtCor Medical Ltd) with pulse wave analysis, calculation of AI@75, and laboratory assessment.

Results: A total of 60 women with SLE or APS were enrolled in the study. Urea level was found to correlate with AI@75 (rho = 0.362, p = 0.006) and PWV (rho = 0.487, p = 0.006). In separate adjusted (age, body mass index, and blood pressure) models, urea (B = 0.722, 95% CI: 0.407-1.037, p < 0.001), uric acid (4.932, 95% CI: 0.447-9.418, p = 0.03), creatinine (B for 0.1 mg/dL increase = 3.367, 95% CI: 1.112-5.601, p = 0.004), and eGFR (B = -0.318, 95%CI: -0.580- -0.055, p = 0.02) were associated with AI@75.

Conclusions: Urea and uric acid values are associated with increased arterial stiffness measured by non-invasive methods such as PWV and AI@75 in women with SLE or APS with normal or slightly reduced glomerular function.