Albuminuria as a marker of arterial stiffness in chronic kidney disease patients

doi:10.5527/wjn.v4.i3.406

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World Journal of Nephrology

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World J Nephrol. Jul 6, 2015; 4(3): 406-414
Published online Jul 6, 2015. doi: 10.5527/wjn.v4.i3.406

Table 1 Demographic and aortic stiffness indices characteristics

Patients characteristics	Study population	Patients with moderately increased albuminuria	Patients with severely increased albuminuria	P value
No	115	58	57	-
Age (yr)	52.6 ± 14.6	51.4 ± 14.4	54.2 ± 15.07	NS
Sex (M/F), (n)	76/39	39/19	37/20	NS
BMI (kg/m²)	30.9 ± 19.3	28.6 ± 4.5	33.9 ± 28.2	< 0.03
Smoking, n (%)	5	3	2	NS
pSBP (mmHg)	138.0 ± 14.2	139 ± 12.7	138.0 ± 15.5	NS
pDBP (mmHg)	84.2 ± 9.7	84.9 ± 10.7	82.6 ± 9.8	NS
pPP (mmHg)	57.9 ± 15.9	56.7 ± 15.1	59.4 ± 16.9	NS
cSBP (mmHg)	130.3 ± 14.6	130 ± 13.3	130.2 ± 16.5	NS
cDBP(mmH)	84.2 ± 9.7	84.9 ± 10.7	84.3 ± 8.6	NS
cPP (mmHg)	48.1 ± 17.6	47.9 ± 17.9	48.4 ± 17.8	NS
AIx (%)	21.1 ± 10.6	18.4 ± 10.0	24.5 ± 10.0	< 0.004
PWVc-f (m/sec)	8.7 ± 2.0	8.3 ± 2.0	9.1 ± 1.9	< 0.02
ACEIs, n (%)
(ramipril or quinapril)	100 (86)	56 (96)	44 (77)	NS
AT1 RB, n (%)
(valsartan or olmesartan)	20 (17.4)	9 (15.5)	11 (19.2)	NS
CCBs, n (%)	11 (9.5)	6 (10.3)	5 (8.7)	NS
Statins, n (%)	7 (6.08)	3 (5.1)	4 (7.01)	NS

Data are presented as mean value. M/F: Male/female; BMI: Body mass index; pSBP: Peripheral systolic blood pressure; pDBP: Peripheral Diastolic blood pressure; pPP: Peripheral pulse pressure; cSBP: Central systolic blood pressure; cDBP: Central diastolic blood pressure; cPP: Central pulse pressure; AIx: Augmentation index; AP: Augmentation pressure; PWVc-f: Pulse wave velocity carotid-femoral; ACEIs: Angiotensin converting enzyme inhibitors; AT1RB: Angiotensin type 1 receptor blockers; CCBs: Calcium channel blockers.

Table 2 Biochemical characteristics of the study population

Patients characteristics	Study population	Patients with moderately increased albuminuria	Patients with severely increased albuminuria	P value
No	115	58	57	-
Ht (%)	42.3 ± 3.7	43.2 ± 3.7	41.4 ± 3.5	0.01
Hb (g/dL)	13.6 ± 1.3	14.1 ± 1.5	13.3 ± 1.5	0.02
Fe (μg/dL)	89 ± 35.5	90.2 ± 30	84.2 ± 38.5	NS
Ferritin (ng/L)	127.4 ± 90.1	127.8 ± 87.9	131.3 ± 96.5	NS
Fibrinogen (mg/dL)	336 ± 82.9	339 ± 86.5	394 ± 133.9	< 0.01
hsCRP (mg/dL)	0.19 ± 0.06	0.18 ± 0.05	0.23 ± 0.10	< 0.001
T-CHOL (mg/dL)	203 ± 37.5	208 ± 39.2	209 ± 46.8	NS
TRG (mg/dL)	126 ± 45.7	123 ± 46.3	145 ± 70.2	0.05
HDL-C (mg/dL)	53.4 ± 13.3	53 ± 12.9	54.2 ± 14.9	NS
LDL-C (mg/dL)	119 ± 32	120 ± 3.7	121 ± 3.6	NS
Ca²⁺ (mg/dL)	9.7 ± 0.4	9.7 ± 0.5	9.8 ± 0.4	NS
PO₄^3- (mg/dL)	3.42 ± 0.4	3.3 ± 0.4	3.5 ± 0.5	0.01
Ca²⁺ x PO₄^3-	33.7 ± 4.8	32.6 ± 4.5	33.9 ± 8.6	NS
PTH (pg/mL)	42.4 ± 15.4	39.8 ± 13.6	45.4 ± 29.9	NS
sAlb (gr/dL)	4.5 ± 0.2	4.5 ± 0.3	4.3 ± 0.5	0.03
eGFR-MDRD (mL/min per 1.73 m²)
eGFR-MDRD (mL/min per 1.73 m²)	92 ± 0.5	91.5 ± 20.5	79.1 ± 15.3	< 0.001
CKD-EPI(mL/min per 1.73 m²)
CKD-EPI(mL/min per 1.73 m²)	73.4 ± 1.25	73.1 ± 13.7	73.6 ± 11.2	NS

Data are presented as mean value. Ht: Haematocrit; Hb: Haemoglobin; Fe: Serum iron; Ferritin: Serum ferritin, hsCRP: High sensitive C-reactive protein; T-CHOL: Total cholesterol; TRG: Triglycerides; HDL-C: High density lipoprotein cholesterol; Ca²⁺: Calcium; PO₄^3-: Phosphorus; PTH: Parathormone; sAlb: Serum albumin; eGFR-MDRD: Estimated-glomerular filtration rate-modification of diet in renal disease; RAAS-blocker: Renin angiotensin aldosterone system blocker; Alb: Albuminuria.

Table 3 Univariate linear regression analysis of the parameters associated with the absolute values of pulse wave velocity

Covariates	β	t	β(95%CI)	P value
Alb	0.841	2.271	0.107-1.574	< 0.025
Age	0.026	2.047	0.001-0.051	< 0.043
BMI	0.009	0.880	0.011-0.028	0.381
pSBP	0.032	2.511	0.007-0.058	< 0.013
pDBP	0.005	0.285	-0.032-0.042	< 0.776
pPP	0.029	2.277	0.004-0.053	< 0.025
cSBP	0.031	2.298	0.004-0.508	< 0.024
cDBP	-0.004	-0.173	-0.045-0.038	0.963
cPP	0.014	1.257	0.008-0.037	0.212
Ht	0.103	2.077	0.005-0.202	0.040
Hb	0.227	1.812	0.020-0.476	0.070
T-CHOL	0.021	0.456	-0.011-0.007	0.649
TRG	0.002	0.752	0.009-0.004	0.454
HDL-C	-0.006	-0.417	-0.033-0.022	0.677
LDL-C	0.023	0.445	0.013-0.477	0.674
Fbrinogen	0.0001	0.524	-0.004-0.002	0.602
hsCRP	-0.011	0.046	-0.442-0.422	0.964
RAAS-blocker	0.081	-0.103	-1.650-1.487	0.918

Alb: Albumin; BMI: Body mass index; pSBP: Peripheral systolic blood pressure; pDBP: Peripheral diastolic blood pressure; pPP: Peripheral pulse pressure; cSBP: Central systolic blood pressure; cDBP: Central diastolic blood pressure; cPP: Central pulse pressure; Ht: Haematocrit; Hb: Haemoglobin; T-CHOL: Total cholesterol; TRG: Triglycerides; HDL-C: High density lipoprotein cholesterol; RAAS-blocker: Renin angiotensin aldosterone system blocker; LDL-C: Low density lipoprotein cholesterol; hsCRP: HsC-reactive protein.

Table 4 Multivariate linear regression analysis of the parameters associated with the absolute values of pulse wave velocity

Covariates	β	t	β(95%CI)	P value
UAlb	1.038	2.638	0.257-1.820	< 0.010
pSBP	0.028	2.149	0.002-0.053	< 0.034
Ht	0.171	3.319	0.069-0.273	< 0.001

pSBP: Peripheral systolic blood pressure; Ht: Haematocrit.

Table 5 Univariate linear regression analysis of the parameters associated with absolute values of Alx

Covariates	β	t	β(95%CI)	P value
UAlb	6.201	2.977	2.065-10.337	< 0.004
Age	0.236	3.427	0.099-0.373	< 0.0001
BMI	0.036	0.667	0.070-0.142	0.507
pSBP	0.291	4.427	0.161-0.422	< 0.0001
pDBP	0.001	0.002	-0.216-0.216	< 0.002
pPP	0.278	4.536	0.156-0.400	< 0.0001
cSBP	0.349	5.518	0.223-0.474	< 0.0001
cDBP	-0.045	-0.401	0.265-0.176	0.689
cPP	0.265	4.912	0.558-0.372	< 0.0001
Ht	-0.848	0.002	-1.382-0.314	< 0.002
Hb	-0.599	-0.826	-2.040-0.841	0.411
T-CHOL	0.050	1.836	-0.041-0.042	0.069
TRG	0.021	1.164	0.015-0.057	0.247
HDL-C	0.104	1.318	-0.534-0.035	0.262
LDL-C	0.047	1.265	-0.045-0.052	0.243
Fbrinogen	0.007	0.749	-0.122-0.273	0.456
hsCRP	0.015	0.732	-1.738-3.768	0.466
RAAS-blocker	1.043	0.139	13.881-15.966	0.890

Table 6 Multivariate linear regression analysis of the parameters associated with the absolute values of Al

Covariates	β	t	β(95%CI)	P value
UAlb	4.385	2.557	1.023-8.146	< 0.012
cSBP	0.242	3.563	0.107-0.376	< 0.0001
cPP	0.147	2.623	0.036-0.259	< 0.0001
Ht	0.591	2.536	1.055-0.128	< 0.013

cSBP: Central systolic blood pressure; cPP: Central pulse pressure; Ht: Haematocrit.

Citation: Kalaitzidis RG, Karasavvidou DP, Tatsioni A, Pappas K, Katatsis G, Liontos A, Elisaf MS. Albuminuria as a marker of arterial stiffness in chronic kidney disease patients. World J Nephrol 2015; 4(3): 406-414
URL: https://www.wjgnet.com/2220-6124/full/v4/i3/406.htm
DOI: https://dx.doi.org/10.5527/wjn.v4.i3.406