Nefrologia最新文献

{"title":"Proyección de la carga clínica y económica de la enfermedad renal crónica entre 2022 y 2027 en España: resultados del proyecto Inside CKD","authors":"Juan F. Navarro González ,&nbsp;Alberto Ortiz ,&nbsp;Ana Cebrián Cuenca ,&nbsp;Marta Moreno Barón ,&nbsp;Lluís Segú ,&nbsp;Belén Pimentel ,&nbsp;Unai Aranda ,&nbsp;Blanca López-Chicheri ,&nbsp;Margarita Capel ,&nbsp;Elisenda Pomares Mallol ,&nbsp;Christian Caudron ,&nbsp;Juan José García Sánchez ,&nbsp;Roberto Alcázar Arroyo","doi":"10.1016/j.nefro.2024.03.002","DOIUrl":"10.1016/j.nefro.2024.03.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>Chronic kidney disease (CKD) is a growing health problem affecting between 10% and 15% of the Spanish population. The lack of updated projections of the evolution of the disease burden hinders the development of evidence-based health policies and interventions to optimize the management of the disease and prevent its progression. The aim of this study is to project the evolution of the clinical and economic burden of CKD in Spain between 2022 and 2027.</div></div><div><h3>Materials and methods</h3><div>Inside CKD uses a validated microsimulation approach to project the burden of CKD. The projection is based on a virtual population according to Spanish demographics, literature, national data registries and clinical expert opinion. Costs associated with CKD management, renal replacement therapy (RRT), cardiovascular complications and arterial comorbidities were included.</div></div><div><h3>Results</h3><div>In Spain, an absolute increase in the prevalence of CKD of 1% (from 10.7% to 11.7%) is expected between 2022 and 2027, corresponding to an increase from 5.14 million to 5.68 million patients in 2027. However, only one third of CKD patients would be diagnosed. Of these diagnosed patients, 3.9% will require RRT in 2027, an increase of 14.7% from 2022. A total of 654,281 accumulated deaths are expected in patients with CKD diagnosed between 2022 and 2027. The economic burden of diagnosed CKD is expected to increase by 13.8% to 4.89 billion euros in 2027, representing 5.56% of total Spanish public health expenditure in 2027 (compared to 4.88% in 2022), of which 42.5% will be allocated to RRT (2.4% of public health expenditure).</div></div><div><h3>Conclusions</h3><div>The Inside CKD project highlights the growing clinical, economic and social burden of CKD in Spain expected by 2027. Progression to more advanced stages with the need for RRT and associated complications represent a small proportion of the total CKD population, but contribute significantly to overall costs.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 807-817"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renata, mi nefróloga, ¿puede la literatura infantil actuar como instrumento de sensibilización y prevención de la enfermedad renal?","authors":"M. Dolores Ojeda Ramírez ,&nbsp;Sergio Garcia-Marcos ,&nbsp;Paula Manso del Real ,&nbsp;Julia Audije-Gil ,&nbsp;M. Dolores Arenas Jiménez","doi":"10.1016/j.nefro.2024.02.008","DOIUrl":"10.1016/j.nefro.2024.02.008","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 894-897"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140084240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effects of dapagliflozin on biomarkers of bone and mineral metabolism in patients with diabetic kidney disease: A prospective observational study","authors":"Tugba Islek ,&nbsp;Safak Mirioglu ,&nbsp;Meltem Gursu ,&nbsp;Rumeyza Kazancioglu ,&nbsp;Metin Demirel ,&nbsp;Sahabettin Selek ,&nbsp;Omer Celal Elcioglu","doi":"10.1016/j.nefro.2024.06.002","DOIUrl":"10.1016/j.nefro.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>There is still a lack of information regarding the impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on bone and mineral metabolism in patients with diabetes and chronic kidney disease (CKD). Therefore, we aimed to investigate the effects of SGLT2i in a cohort of patients suffering from diabetic kidney disease (DKD).</div></div><div><h3>Methods</h3><div>In this prospective observational study, patients with type 2 diabetes and biopsy-proven diabetic nephropathy or presumptive DKD with eGFR levels ≥20 ml/min/1.73m2 and 25-OH vitamin D levels ≥20 ng/dl were included. 41 used SGLT2i (study group) and 39 continued their current treatment regimens (control group). Serum FGF-23, sclerostin, osteoprotegerin (OPG), and hydroxyproline levels were measured at baseline, 1 month and 3 months after treatment.</div></div><div><h3>Results</h3><div>Mean age of all patients was 67<!--> <!-->±<!--> <!-->9.3 years, and 48 (60%) were female. All patients in the study group used dapagliflozin. Taking into account the renal functions at the commencement of the study, the eGFR values for the study group and the control group were 51.2<!--> <!-->±<!--> <!-->15.6 and 44.6<!--> <!-->±<!--> <!-->16.9<!--> <!-->ml/min/1.73m², respectively (p<!--> <!-->=<!--> <!-->0.01). After three months, these values were observed to be 47.4<!--> <!-->±<!--> <!-->16.7 and 44.3<!--> <!-->±<!--> <!-->18.8 ml/min/1.73m² (p<!--> <!-->=<!--> <!-->0.43), respectively. At baseline, OPG levels were higher in the study group (p<!--> <!-->=<!--> <!-->0.025) but there were no differences between the groups in terms of FGF-23 and sclerostin levels (p<!--> <!-->=<!--> <!-->0.670 and p<!--> <!-->=<!--> <!-->0.467, respectively). Levels of OPG, FGF-23, and sclerostin significantly decreased throughout 3 months of treatment with dapagliflozin (p<!--> <!-->&lt;<!--> <!-->0.001 for all). Hydroxyproline levels also declined but did not reach to statistical significance (p<!--> <!-->=<!--> <!-->0.075). Multiple linear regression models revealed that treatment with SGLT2i was associated with the change in levels of sclerostin (β=0.303, p<!--> <!-->=<!--> <!-->0.011) and OPG (β=0.210, p<!--> <!-->=<!--> <!-->0.010), but not with FGF-23 (β=0.089, p<!--> <!-->=<!--> <!-->0.150).</div></div><div><h3>Conclusions</h3><div>FGF-23, sclerostin and OPG levels significantly declined after treatment with dapagliflozin for 3 months.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 868-876"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uso de los agonistas del receptor del péptido similar al glucagón tipo 1 en pacientes trasplantados renales","authors":"Luis Alberto Vigara ,&nbsp;Florentino Villanego ,&nbsp;Cristhian Orellana ,&nbsp;Myriam Eady ,&nbsp;María Gabriela Sánchez ,&nbsp;Marta Alonso ,&nbsp;María Belén García ,&nbsp;José Manuel Amaro ,&nbsp;Teresa García ,&nbsp;Auxiliadora Mazuecos","doi":"10.1016/j.nefro.2023.06.010","DOIUrl":"10.1016/j.nefro.2023.06.010","url":null,"abstract":"<div><h3>Introduction</h3><div>In kidney transplant (KT) recipients, diabetes mellitus (DM) are associated with an increased mortality and a poorer graft survival. Glucagon-like peptide 1 receptor agonists (GLP1-RA) have demonstrated cardiovascular and renal benefits in the general population. However, there is lacking evidence in KT recipients.</div></div><div><h3>Objective</h3><div>To analyze the efficacy and safety of glucagon-like peptide 1 receptor GLP1-RA in a cohort of KT recipients.</div></div><div><h3>Methods</h3><div>Multicenter retrospective cohort study of KT patients with DM who started subcutaneous GLP1-RA in three hospitals in the province of Cádiz between February 2016 and July 2022. Estimated glomerular filtration rate (eGFR), proteinuria, and weight at baseline and after 6 and 12 months were collected. We analyzed glycemic control, blood pressure, lipid profile, and doses and trough levels of tacrolimus. We document episodes of acute rejection (AR), de novo donor-specific antibodies (dnDSA), and adverse effects.</div></div><div><h3>Results</h3><div>During this period, 96 KT with DM started treatment with GLP1-RA, of which 84 had a minimum follow-up of 6 months and 61 were followed for 12 months. A significant reduction was observed in proteinuria (−19.1 mg/g, <em>P</em> = .000; −46.6 mg/g, <em>P</em> = .000), weight (−3.6 kg, <em>P</em> = .000; −3.6 kg, <em>P</em> = .000), glycosylated hemoglobin (−0.7%, <em>P</em> = .000; −0.9%, <em>P</em> = .000), systolic blood pressure (−7.5 mmHg, <em>P</em> = .013; −7.3 mmHg, <em>P</em> = .004), total cholesterol (−11.5 mg/dl, <em>P</em> = .001; −15.6 mg/dl, <em>P</em> = .002) and LDL cholesterol (−9.2 mg/dl, <em>P</em> = .002; −16.8 mg/dl, <em>P</em> = .000) at 6 months and 1 year of follow-up. The eGFR remained stable and the dose and trough levels of tacrolimus did not change. No episodes of AR or development of dnDSA were observed during follow-up.</div></div><div><h3>Conclusions</h3><div>GLP1-RA in KT patients can be a safe and effective option for the management of DM in KT.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 885-893"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44783993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluación de eventos clínicos y costes asociados a la adición de dapagliflozina al tratamiento de la enfermedad renal crónica: análisis de compensación de costes","authors":"Juan Francisco Navarro-González ,&nbsp;Alberto Ortiz ,&nbsp;Ana Cebrián Cuenca ,&nbsp;Lluís Segú ,&nbsp;Belén Pimentel ,&nbsp;Unai Aranda ,&nbsp;Blanca Lopez-Chicheri ,&nbsp;Margarita Capel ,&nbsp;Elisenda Pomares Mallol ,&nbsp;Christian Caudron ,&nbsp;Juan José García Sánchez ,&nbsp;Roberto Alcázar Arroyo","doi":"10.1016/j.nefro.2024.05.010","DOIUrl":"10.1016/j.nefro.2024.05.010","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Chronic kidney disease (CKD) is a serious health problem with an increasing clinical, social and economic impact in advanced stages. Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor that reduces the risk of CKD progression, in addition to provide cardiovascular benefits and reduce all-cause mortality. The aim of this study was to determine the short-term clinical and economic impact of dapagliflozin as an add-on to renin-angiotensin-aldosterone system inhibitors (RAASi) standard therapy for CKD in Spain.</div></div><div><h3>Materials and methods</h3><div>A cost-offset model was used to compare the costs of clinical events and pharmacological per 100,000 CKD patients in a virtual cohort treated with dapagliflozin added to RAASi standard therapy versus RAASi standard therapy alone. Renal (progression to renal failure and acute kidney injury), cardiovascular (hospitalisation for heart failure [HF]), and all-cause mortality events were assessed. The incidence of clinical events by treatment arm was obtained from the DAPA-CKD study, and costs were obtained from national databases and the literature.</div></div><div><h3>Results</h3><div>Over 3 years, treatment with dapagliflozin would reduce progression to renal failure (−33%; 7,221 vs. 10,767), hospitalisation for HF (−49%; 2,370 vs. 4,683) and acute kidney injury (−29%; 4,110 vs. 5,819). The savings associated with this reduction in events was €258 million per 100,000 patients, of which 63.4% is due to the avoidance of dialysis for renal failure. Considering the event and pharmacological treatment costs, the total net savings were estimated at €158 million per 100,000 patients.</div></div><div><h3>Conclusions</h3><div>Delaying progression of CKD and reducing the incidence of clinical events thanks to the treatment with dapagliflozin could generate savings for the Spanish National Health System, even when pharmacological costs are taken into account.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 857-867"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141135946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectivity and safety profile of tenapanor, a sodium-hydrogen exchanger isoform 3 inhibitor, as an innovative treatment for hyperphosphatemia in chronic kidney disease: A systematic review of clinical studies","authors":"William Suciangto ,&nbsp;Haerani Rasyid ,&nbsp;Anastasya Angelica Vicente ,&nbsp;Winny Suciangto","doi":"10.1016/j.nefro.2024.06.007","DOIUrl":"10.1016/j.nefro.2024.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is a major global health problem. Hyperphosphatemia is frequent in CKD and a reason for increased morbidity and mortality as it generates hyperparathyroidism, high fibroblast growth factor 23 (FGF23), and hypocalcemia. Available hyperphosphatemia therapies still have limitations, including risk of metal overload, cardiovascular calcification, and systemic adverse effects (AEs). Tenapanor is a new hyperphosphatemia treatment in CKD with sodium-hydrogen exchanger isoform 3 (NHE3) inhibition mechanism and low systemic AEs.</div></div><div><h3>Objectives</h3><div>Discovering the effectivity and safety of tenapanor as hyperphosphatemia management in CKD.</div></div><div><h3>Method</h3><div>Literature searching is performed by using “pubmed” and “science direct” with “tenapanor”, “chronic kidney disease”, and “hyperphosphatemia” as keywords. The literatures were selected using PRISMA algorithm version 2020. Literature was screened based on Population, Intervention, Comparison, and Outcome (PICO) criteria which are: CKD patients requiring dialysis as population, tenapanor or its combination with dialysis or phosphate binders as intervention, placebo or other phosphate binders without tenapanor as comparison, and serum phosphate, safety profile, and other pleiotropic benefits related to hyperphosphatemia management as the outcome. The included studies then assessed for risk of bias and qualitatively reviewed.</div></div><div><h3>Outcome</h3><div>Tenapanor was able to reduce serum phosphate, generally in a dose-dependent manner. Tenapanor also suppressed FGF23 and parathyroid hormone, probably due to decreased serum phosphate. The frequent AEs were transient mild-to-moderate diarrhea in a dose-dependent manner. Tenapanor was generally well-tolerated with low systemic AEs due to its non-calcium, metal-free, and low-absorbed properties.</div></div><div><h3>Conclusion</h3><div>Tenapanor is an effective and safe option for hyperphosphatemia management in CKD.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 796-806"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El aluvión migratorio en hemodiálisis","authors":"Claudia Yuste Lozano","doi":"10.1016/j.nefro.2024.05.003","DOIUrl":"10.1016/j.nefro.2024.05.003","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 897-899"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Es útil medir el grosor de la grasa peri-pararrenal mediante ultrasonografía como marcador de riesgo cardiovascular en pacientes obesos con enfermedad renal crónica?","authors":"José C. De La Flor Merino ,&nbsp;Carlos Narváez Mejía ,&nbsp;Adriana Puente García ,&nbsp;Jonay Pantoja Pérez ,&nbsp;Michael Cieza Terrones ,&nbsp;Maite Rivera Gorrín","doi":"10.1016/j.nefro.2024.08.001","DOIUrl":"10.1016/j.nefro.2024.08.001","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 915-920"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La definición del síndrome cardiovascular-reno-metabólico (cardiovascular-kidney-metabolic syndrome) y su papel en la prevención, estatificación del riesgo y tratamiento. Una oportunidad para la Nefrología","authors":"Aleix Cases ,&nbsp;Jose Jesus Broseta ,&nbsp;Maria Marqués ,&nbsp;Secundino Cigarrán ,&nbsp;Juan Carlos Julián ,&nbsp;Roberto Alcázar ,&nbsp;Alberto Ortiz","doi":"10.1016/j.nefro.2024.05.001","DOIUrl":"10.1016/j.nefro.2024.05.001","url":null,"abstract":"<div><div>The recent conceptualization of the cardiovascular-kidney-metabolic (CKM) syndrome by the American Heart Association (AHA) opens an opportunity for a multidisciplinary and lifelong approach in the risk stratification, early prevention, and treatment of the vicious circle generated by the interaction of cardiovascular, renal and metabolic risk factors and aggravated by the development of cardiovascular diseases (including their full spectrum: heart failure, atrial fibrillation, coronary heart disease, stroke, and peripheral arterial disease), chronic kidney disease or type<!--> <!-->2 diabetes mellitus, with the excess or dysfunctional adiposity as the trigger. Three publications offer the rational basis of a conceptual decalogue and action plan and a new cardiovascular risk stratification equation since the age of 30 that includes measures of renal function/damage, among others, to promote effective cardiovascular, renal, and metabolic prevention. In Spain, we must leverage this momentum to adapt these new concepts to our reality with greater and improved collaboration between primary care and the specialties involved in CKM syndrome, including the formation of multidisciplinary units for the optimal management using a patient-centred approach.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 771-783"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio de la asociación de marcadores de rigidez arterial central y periférica con la función renal en pacientes con hipertensión arterial, diabetes mellitus y enfermedad renal crónica","authors":"Jary Perelló Martínez ,&nbsp;Alfredo Michán Doña ,&nbsp;Rafael Santamaría Olmo ,&nbsp;Juan Carlos Hidalgo Santiago ,&nbsp;Josefina Gálvez Moral ,&nbsp;Pablo Gómez-Fernández","doi":"10.1016/j.nefro.2024.05.005","DOIUrl":"10.1016/j.nefro.2024.05.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale and objectives&lt;/h3&gt;&lt;div&gt;Increased aortic or central arterial stiffness (CAS) is a major factor in cardiovascular morbidity and mortality in patients with vascular risk factors. Decreased glomerular filtration rate (GFR) and increased urinary albumin excretion (uALB) are associated with lethal and non-lethal cardiovascular events. The pathophysiological mechanisms of this association are not fully defined.&lt;/div&gt;&lt;div&gt;The aim of this study was: 1.- To analyze the CAS, comparing several markers, in subjects with arterial hypertension (HTN), diabetes mellitus (DM), chronic kidney disease (CKD) and their combination. 2.- To study the possible association of CAS with renal dysfunction (decrease in GFR and increase in uALB).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;A total of 286 subjects were included, divided into several groups: Control (n: 38); HTN (n:51); DM without CKD (n:26); CKD without DM (n:77); CKD with DM (n:94). Several indices obtained by applanation tonometry were used to determine the CAS: carotid-femoral pulse velocity (VP&lt;sub&gt;&lt;strong&gt;c-f&lt;/strong&gt;&lt;/sub&gt;); central pulse pressure (cPP); augmentation index standardized to a cardiac frequency of 75 l/min (IA&lt;sub&gt;&lt;strong&gt;75&lt;/strong&gt;&lt;/sub&gt;); peripheral / aortic arterial stiffness gradient (ASG&lt;sub&gt;p-a&lt;/sub&gt;). As a marker of peripheral arterial stiffness, the carotid-radial pulse velocity (PV&lt;sub&gt;c-r&lt;/sub&gt;) was determined. The ASG&lt;sub&gt;p-a&lt;/sub&gt; was calculated from the PV&lt;sub&gt;c-r&lt;/sub&gt; /PV&lt;sub&gt;c-f&lt;/sub&gt; ratio. The subendocardial viability index (iBuckberg) was obtained from the aortic pulse wave.&lt;/div&gt;&lt;div&gt;Multiple regression, binary logistic regression, and multinomial regression were used to study the association between arterial stiffness markers and renal function.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The adjusted values of the PV&lt;sub&gt;c-f&lt;/sub&gt; [(median (interquartile range) (m/sec)] were significantly higher in subjects with DM [(9 (1.2)], CKD [(9.4 (0.7)] and DM with CKD [(10.9 (0.7)] than in the control group [(8.2 (1.3)] and group with HTN [(8.3 (0.9)], (p:0.001). Patients with DM with CKD had higher PV&lt;sub&gt;&lt;strong&gt;c-f&lt;/strong&gt;&lt;/sub&gt; values than all other groups (p: 0.001). The ASG&lt;sub&gt;&lt;strong&gt;p-a&lt;/strong&gt;&lt;/sub&gt; of the patients was significantly lower than that of the controls, and the group with DM with CKD had significantly lower values than the other groups. The cPP in the DM with CKD group was significantly higher than in the other groups. All patients had an AI&lt;sub&gt;75&lt;/sub&gt; higher than the control group.&lt;/div&gt;&lt;div&gt;When all aortic stiffness markers were introduced together in the regression, PV &lt;sub&gt;&lt;strong&gt;c-f&lt;/strong&gt;&lt;/sub&gt; was the only one that, after multivariate adjustment, was independently and inversely associated with GFR (β; –4, p:0.001) and predicted the presence of GFR decrease (&lt; 60&lt;!--&gt; &lt;!--&gt;mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;), [(OR (95%CI): 1.50 (1.17-1.92; p:0.001]. The PV&lt;sub&gt;&lt;strong&gt;c-f&lt;/strong&gt;&lt;/sub&gt; was the only index directly associated with ","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 6","pages":"Pages 830-845"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}