Work

Arterial Stiffness and Acute Kidney Injury in the Atherosclerosis Risk in Communities (ARIC) Study

Year: 2025

Type: article

Abstract: Rationale & Objective: Acute kidney injury (AKI) is associated with prolonged hospitalization and increased in-hospital mortality risk. However, the prediction of incident AKI is inaccurate, and additional predictors of AKI are strongly needed. Arterial stiffness, as measured using carotid-femoral pulse wave velocity (cfPWV), is associated with kidney function decline and may serve as a plausible predictor of AKI. We hypothesized a higher cfPWV at baseline would be independently associated with AKI risk in community-dwelling older adults who participated in the Atherosclerosis Risk in Communities study. Study Design: Observational cohort study. Setting & Participants: Community-dwelling older adults from the Atherosclerosis Risk in Communities study. Predictors: The primary predictor was cfPWV and secondary predictors were heart-femoral pulse wave velocity (PWV), heart-carotid PWV, heart-ankle PWV, and brachial-ankle PWV, and femoral-ankle PWV. Outcomes: Time to AKI, defined by International Classification of Diseases (ICD) codes. Analytical Approach: Cox proportional hazard models were used to examine the association between PWV measures and time to AKI. Given its J-shaped relation with AKI, PWV was modeled as a categorical variable in quartiles (Q), with Q2 serving as the reference category. Results: A total of 4,245 participants (44% male; 77% White; mean ± SD age 75 ± 5 years; cfPWV 11.9 ± 3.9 m/s) were included. There was a J-shaped association between cfPWV and AKI risk (Q1, hazard ratio 1.15 [95% confidence interval 0.90-1.46]; Q4, 1.38 [1.08-1.77] vs Q2 reference) after fully adjusting for demographics, cardiovascular disease risk factors, and markers for kidney function and peripheral artery disease. Limitations: Most of the participants were White; and AKI was defined based on ICD codes. Conclusions: Higher arterial stiffness, measured by cfPWV, may potentially serve as a predictor of AKI risk in community-dwelling older adults.

Source: Kidney Medicine

DOI: 10.1016/j.xkme.2025.101124