Acute kidney injury (AKI) is independently associated with arterial stiffness, according to investigators.
Their study of 613 participants in SPRINT (Systolic Blood Pressure Intervention Trial) revealed that each 1 m/s increase in carotid-femoral pulse wave velocity (PWV) — the gold standard for measuring arterial stiffness — was significantly associated with a 32% increased risk for AKI in a fully adjusted model, corresponding author Anna Jovanovich, MD, of the University of Colorado’s Anschutz Medical Campus in Aurora, and colleagues reported in the Clinical Journal of the American Society of Nephrology.
Compared with a carotid-femoral PWV below the median (10.4 m/s), a value of 10.4 m/s or higher was significantly associated with a nearly 13.3-fold increased risk for AKI.
“Our results support consideration of including arterial stiffness into risk prediction models for AKI and as a target for prevention or therapeutic treatment of AKI,” the authors concluded.
“However, further inquiry in larger and more diverse populations, including healthy individuals and those with diabetes, are needed to validate these hypothesis-generating findings.”
The investigators adjusted for age, race, sex, smoking category, history of cardiovascular disease, number of antihypertensive medications, estimated glomerular filtration rate (eGFR), and other potential confounders.
SPRINT was a randomized trial comparing the effect of intensive blood pressure treatment to standard treatment on cardiovascular outcomes in 9361 hypertensive participants without diabetes.
The 613 participants in the new analysis had a mean age of 72 years; 40% were women and 69% were White. The mean eGFR of the study population was 67 mL/min/1.73 m2.
Study strengths included use of data from a large multicenter trial, “which allowed us to account for many important confounders.” The authors acknowledged, however, that the study is limited in its generalizability because it only included participants in SPRINT, who were older, hypertensive adults without diabetes at high risk for cardiovascular disease.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Pengshung MH, Bispham NZ, You Z, et al. Arterial stiffness is independently associated with acute kidney injury in SPRINT. Clin J Am Soc Nephrol. Published online August 27, 2021. doi:10.2215/CJN.06420521