ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2012
Association of pulse pressure, arterial elasticity, and endothelial function with kidney function decline among adults with estimated GFR >60 mL/min/1.73 m(2): the Multi-Ethnic Study of Atherosclerosis (MESA).
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
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54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- GFR in Healthy Aging: an Individual Participant Data Meta-Analysis of Iohexol Clearance in European Population-Based Cohorts.Journal of the American Society of Nephrology : JASN · 2020Pooled it
- Arterial Stiffness and Decline in Kidney Function.Clinical journal of the American Society of Nephrology : CJASN · 2015Pooled it
- Exercise in patients with hypertension and chronic kidney disease: a randomized controlled trial.Journal of human hypertension · 2018Trial
- Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study.Journal of human hypertension · 2017Trial
- Trial
- Short-term aerobic exercise and vascular function in CKD stage 3: a randomized controlled trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2014Trial
- The Retinal Vasculature and Risk of Age-Related GFR Decline - The Renal Iohexol Clearance Survey.Kidney international reports · 2025Article
- Association of Pulse Prssure Index With Mortality in Patients With Hypertension: Results From NHANES 1999-2018.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Osteoprotegerin and Vascular Dysfunction in Patients with Stage 3 Chronic Kidney Disease and Those without Renal Dysfunction: A Case-Control Study.Arquivos brasileiros de cardiologia · 2024Article
- Ambulatory blood pressure as risk factor for long-term kidney function decline in the general population: a distributional regression approach.Scientific reports · 2023Article
- Endothelial function, arterial stiffness and Framingham risk score in chronic kidney disease: A prospective observational cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Observational
- Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions.Journal of personalized medicine · 2023Review
- Association between pulse pressure, systolic blood pressure and the risk of rapid decline of kidney function among general population without hypertension: results from the China health and retirement longitudinal study (CHARLS).Journal of translational medicine · 2021Article
- Sex modulates the association of radial artery augmentation index with renal function decline in individuals without chronic kidney disease.International urology and nephrology · 2021Article
- The distribution of eGFR by age in a community-based healthy population: the Japan specific health checkups study (J-SHC study).Clinical and experimental nephrology · 2021Article
- The role of pulse pressure in navigating the paradigm of chronic kidney disease progression in type 2 diabetes mellitus.Journal of nephrology · 2021Article
- Clinical features of and risk factors for normoalbuminuric diabetic kidney disease in hospitalized patients with type 2 diabetes mellitus: a retrospective cross-sectional study.BMC endocrine disorders · 2021Article
- Distribution of estimated glomerular filtration rate and determinants of its age dependent loss in a German population-based study.Scientific reports · 2021Observational
- Association ofJournal of the American Heart Association · 2020Article
- Arterial Stiffness Predicts Rapid Decline in Glomerular Filtration Rate Among Patients with High Cardiovascular Risks.Journal of atherosclerosis and thrombosis · 2020Article
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Authors and funding
12 authors at 11 institutions in 2 countries.
Funding
Abstract
backgroundThe association of subclinical vascular disease and early declines in kidney function has not been well studied. STUDY
designProspective cohort study. SETTING &
participantsMulti-Ethnic Study of Atherosclerosis (MESA) participants with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2) with follow-up of 5 years. PREDICTORS: Pulse pressure, small (SAE) and large arterial elasticity (LAE), and flow-mediated dilation. OUTCOMES: Kidney function decline. MEASUREMENTS: SAE and LAE were measured by pulse contour analysis of the radial artery. Kidney function was assessed by eGFR based on serum creatinine (eGFR(SCr)) and cystatin C (eGFR(SCysC)).
resultsFor 4,853 adults, higher pulse pressure and lower SAE and LAE had independent and linear associations with faster rates of kidney function decline. Compared with persons with pulse pressure of 40-50 mm Hg, eGFR(SCysC) declines were 0.29 (P = 0.006), 0.56 (P < 0.001), and 0.91 (P < 0.001) mL/min/1.73 m(2)/y faster in persons with pulse pressure of 50-60, 60-70, and >70 mm Hg, respectively. Compared with the highest quartile of SAE (most elastic), eGFR(SCysC) declines were 0.26 (P = 0.009), 0.35 (P = 0.001), and 0.70 (P < 0.001) mL/min/1.73 m(2)/y faster for the second, third, and fourth quartiles, respectively. For LAE, compared with the highest quartile, eGFR(SCysC) declines were 0.28 (P = 0.004), 0.58 (P < 0.001), and 0.83 (P < 0.001) mL/min/1.73 m(2)/y faster for each decreasing quartile of LAE. Findings were similar for eGFR(SCr). In contrast, for 2,997 adults with flow-mediated dilation and kidney function measures, flow-mediated dilation was not associated significantly with kidney function decline. For every 1-standard deviation greater flow-mediated dilation, eGFR(SCysC) and eGFR(SCr) changed by 0.05 (P = 0.3) and 0.06 mL/min/1.73 m(2)/y (P = 0.04), respectively. LIMITATIONS: We had no direct measure of GFR, in common with nearly all large population-based studies.
conclusionsHigher pulse pressure and lower arterial elasticity, but not flow-mediated dilation, were associated linearly and independently with faster kidney function decline in persons with eGFR ≥60 mL/min/1.73 m(2). Future studies should investigate whether treatments to decrease the stiffness of large and small arteries may slow the rate of kidney function loss.
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