Estimated pulse wave velocity and incident chronic kidney disease: evidence from a prospective cohort and meta-analysis

IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Fan Zhang, Yan Bai, Liuyan Huang, Yifei Zhong
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Abstract

Aims

This study aims to investigate the association between estimated pulse wave velocity (ePWV) and risk of incident chronic kidney disease (CKD).

Methods

A total of 3,240 participants aged ≥45 years without baseline CKD were included. Additionally, a meta-analysis of 18 studies involving 209,970 participants was conducted. ePWV was calculated using age and mean arterial pressure, with participants categorized into tertiles: lower (<8.36 m/s), medium (8.36–9.91 m/s), and higher (≥9.92 m/s). Incident CKD was defined as physician-diagnosed CKD or estimated glomerular filtration rate <60 mL/min/1.73 m2 based on cystatin C.

Results

During a median follow-up of 9.0 years, 494 participants (15.2 %) developed CKD. After adjusting for potential confounders, compared with the lower-ePWV group, the hazard ratios for CKD were 1.26 (95 % CI, 0.96–1.66) in the medium-ePWV group and 1.53 (95 % CI, 1.07–2.17) in the higher-ePWV group. Each standard deviation increase in ePWV was associated with a 42 % higher risk (HR = 1.42; 95 % CI, 1.23–1.63). Meta-analysis confirmed this association (pooled HR = 1.58; 95 % CI, 1.36–1.83) with evidence of a nonlinear dose–response relationship.

Conclusion

Higher ePWV was independently associated with increased risk of incident CKD. These findings suggest that ePWV may serve as a valuable tool for early CKD risk stratification in clinical practice.
估计脉搏波速度和慢性肾脏疾病的发生:来自前瞻性队列和荟萃分析的证据。
目的:本研究旨在探讨估计脉搏波速度(ePWV)与发生慢性肾脏疾病(CKD)的风险之间的关系。方法:共纳入3240名年龄≥45 岁无基线CKD的参与者。此外,对涉及209,970名参与者的18项研究进行了荟萃分析。ePWV使用年龄和平均动脉压来计算,参与者分为以下几组:低(结果:在中位随访9.0 年期间,494名参与者(15.2% %)发展为CKD。在调整潜在混杂因素后,与低epwv组相比,中等epwv组CKD的风险比为1.26(95 % CI, 0.96-1.66),高epwv组为1.53(95 % CI, 1.07-2.17)。ePWV的每一个标准差增加与42 %的高风险相关(HR = 1.42;95 % CI, 1.23-1.63)。荟萃分析证实了这种关联(合并HR = 1.58;95% % CI, 1.36-1.83),并证实了非线性剂量-反应关系。结论:较高的ePWV与CKD发生风险增加独立相关。这些发现表明ePWV可能在临床实践中作为早期CKD风险分层的有价值的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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