Arterial stiffness in non-dialysis patients with diabetic kidney disease and its influence on prognosis

Abstract:

Objective：To investigate arterial stiffness in non-dialysis patients with diabetic kidney disease（DKD） and its influence on cardiovascular death and all-cause death. Methods：A total of 54 non-dialysis DKD patients who were admitted to People’s Hospital，Peking University，from April 2006 to November 2010 were enrolled，and carotid-femoral pulse wave velocity（CFPWV） was measured after admission. According to CFPWV，these patients were divided into increased CFPWV group（CFPWV≥12 m/s） and normal group（CFPWV<12 m/s） and were followed up to observe cardiovascular death and all-cause death. The Kaplan-Meier method and the Cox proportional hazards model were used for the multivariate analysis of influencing factors for prognosis. Results：The mean follow-up time was 79.7±41.3 months for all patients. Compared with the normal group，the increased CFPWV group had significantly higher rates of all-cause death（76.9% vs 33.3%，P<0.01） and cardiovascular death（58.7% vs 13.3%，P<0.01）. The death group had a sig－nificantly higher CFPWV value than the survival group（P<0.01）. The Kaplan-Meier curves of cardiovascular death and all-cause death in the increased CFPWV group were well separated from those in the normal group，and the increased CFPWV group had significantly higher rates of cardiovascular death and all-cause death than the normal group. The multivariate Cox regression analysis revealed that high CFPWV，increase in C-reactive protein，and reduction in corrected calcium were the independent risk factors for cardio－vascular death and all-cause death（P<0.05）. Conclusion：Non-dialysis DKD patients with increased CFPWV have higher rates of cardiovascular death and all -cause death than those with normal CFPWV，and increased CFPWV is an independent risk factor for cardiovascular death and all-cause death in non-dialysis DKD patients with stage 3-5 chronic kidney disease.