Greater aortic stiffness is associated with renal dysfunction in participants of the ELSA-Brasil cohort with and without hypertension and diabetes

Arterial stiffness has been associated with renal dysfunction and its progression, but the pathophysiological relation underlying this association has not been fully established, particularly among individuals without hypertension and diabetes. We investigated the cross-sectional associations betwee...

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Published in:	PloS one Vol. 14; no. 2; p. e0210522
Main Authors:	Cândido, Júlia S A, Camelo, Lidyane V, Mill, José Geraldo, Lotufo, Paulo A, Ribeiro, Antonio Luiz P, Duncan, Bruce B, Brant, Luisa C C, Barreto, Sandhi Maria
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 04-02-2019 Public Library of Science (PLoS)
Subjects:	Adult Adults Aged Albuminuria - complications Albuminuria - epidemiology Albuminuria - physiopathology Antihypertensive agents Antihypertensives Aorta Biology and Life Sciences Blood pressure Body mass Body mass index Body size Brazil - epidemiology Cardiovascular agents Cardiovascular disease Cardiovascular diseases Cholesterol Chronic kidney failure Cohort Studies Creatinine Cross-Sectional Studies Development and progression Diabetes Diabetes Complications - complications Diabetes Complications - epidemiology Diabetes Complications - physiopathology Diabetes mellitus Dosage and administration Drug therapy Epidermal growth factor receptors Ethics Female Femur Glomerular Filtration Rate Glucose Glycosylated hemoglobin Heart rate Hemoglobin Hemoglobins High density lipoprotein Hospitals Humans Hypertension Hypertension - complications Hypertension - epidemiology Hypertension - physiopathology Kidney diseases Kidney failure Male Medical schools Medicine and Health Sciences Middle Aged Mortality Physical Sciences Physiology Population Renal function Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology Smoking Stiffness Studies Systematic review Vascular diseases Vascular Stiffness Wave velocity Brazil Rio Grande do Sul Brazil
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Summary:	Arterial stiffness has been associated with renal dysfunction and its progression, but the pathophysiological relation underlying this association has not been fully established, particularly among individuals without hypertension and diabetes. We investigated the cross-sectional associations between arterial stiffness and renal function in adults without cardiovascular disease, and whether this association remained among subjects without hypertension and diabetes. All eligible participants from ELSA-Brasil (2008-2010), aged 35 to 74 years (N = 13,586) were included, of whom 7,979 were free from hypertension and diabetes. The response variables were: 1) low glomerular filtration rate (eGFR<60ml/min/1.73m2) estimated by CKD-EPI; 2) increased albumin/creatinine ratio (ACR ≥30mg/g); and 3) chronic kidney disease (CKD). Arterial stiffness was ascertained by the carotid-femoral pulse wave velocity (PWV). The covariates were sex, age, race/color, level of schooling, smoking, body mass index, total cholesterol/HDL-c glycated hemoglobin, diabetes, systolic blood pressure, heart rate and use of antihypertensive drugs. Logistic regression was used to examine the associations. After all adjustments, 1 m/s increase in PWV was associated with ORs equal to 1.10 (95%CI: 1.04-1.16), 1.10 (95%CI: 1.05-1.16) and 1.12 (95%CI: 1.08-1.17) of low eGFR, high ACR, and CKD, respectively. In subjects without hypertension and diabetes, these ORs were 1.19 (95%CI: 1.07-1.33), 1.20 (95%CI: 1.07-1.32) and 1.21 (95%CI: 1.11-1.30), respectively. The increase in PWV was associated with all renal dysfunction markers, even in individuals without hypertension and diabetes, suggesting a relation that is not completely mediated by the presence of these conditions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0210522