Association Between Estimated Pulse Wave Velocity and Carotid Plaques in Non-Dialysis CKD Stages 3–5: A Cross-Sectional Study

Abstract

Carotid plaques are common in CKD patients and serve as a key marker of cardiovascular risk. Arterial stiffness, assessed by estimated pulse wave velocity (ePWV), is a valuable non-invasive indicator of vascular health. However, the association between ePWV and carotid plaques in CKD stages 3–5 remains unclear. Of the 296 participants, 199 were included in the cross-sectional study after applying exclusion criteria. Carotid plaques were assessed using ultrasound, and ePWV was calculated based on established equations. Logistic regression models examined the association between ePWV and carotid plaques, while subgroup and mediation analyses evaluated the robustness of the association and mediating effects, respectively. ePWV was significantly associated with carotid plaques (OR: 1.85; 95% CI: 1.47–2.32; p < 0.001) after adjusting for covariates. The highest ePWV tertile (ePWV ≥ 11.2 m/s) was associated with a markedly increased risk of carotid plaques compared to the lowest tertile (OR: 21.52; 95% CI: 7.09–65.36; p < 0.001), and trends between tertiles have been observed. Subgroup analysis showed that diabetes influenced the robustness of the association between ePWV and carotid plaque. Mediation analysis revealed that ePWV accounted for 32.9% of the effect of diabetes on carotid plaques, indicating its potential role as a partial mediator. This study identified a robust association between ePWV and carotid plaques in CKD stages 3–5, with diabetes significantly influencing this relationship. The findings highlighted the clinical relevance of ePWV in cardiovascular risk assessment and underscored the importance of managing arterial stiffness in advanced CKD populations.