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Background <p>The effect of arterial stiffness (AS) on incident chronic kidney disease (CKD) in healthy individuals remains unclear. In this study, we examined the relationship between AS, measured using brachial-ankle pulse wave velocity (baPWV), and cardiovascular-metabolic comorbidities in predicting CKD development.</p> Methods <p>This two-phase retrospective cohort study used data from the Chinese People’s Liberation Army General Hospital (2009–2021). The cross-sectional phase included 83,354 participants (77,711 without CKD and 5,643 with CKD), whereas the longitudinal phase included 13,738 participants. The association between baPWV and incident CKD was assessed using Cox regression analysis with restricted cubic splines, stratification, and mediation.</p> Results <p>CKD exhibited a prevalence of 6.77%. Participants with CKD had significantly higher baPWV than those without CKD. Compared to the reference category (&lt; 1,400&#xa0;cm/s), participants with baPWV ≥ 1,800&#xa0;cm/s showed markedly increased odds of CKD development. Longitudinal analysis identified 403 incident CKD cases (2.93%) over a mean follow-up of 2.95 ± 2.02 years. A dose–response relationship was observed between baPWV and CKD development (<i>p</i> &lt; 0.001), with the highest baPWV category conferring a 65% greater risk (<i>p</i> &lt; 0.05). Mediation analysis showed significant indirect effects through systolic blood pressure (52.9%), diastolic blood pressure (45.1%), hyperlipidaemia (27.5%), and glycated haemoglobin (15.3%) (all <i>p</i> &lt; 0.05).</p> Conclusions <p>Elevated baPWV values are associated with greater incident CKD risk, with blood pressure and glucose-lipid metabolism dysfunction potentially mediating this association. Further research is needed to determine whether interventions targeting AS and metabolic parameters reduce CKD incidence.</p>

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Arterial stiffness and incident chronic kidney disease risk: a two-phase retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月4日

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  • Guang Yang,
  • Xin Shen,
  • Ying Ding,
  • Bokai Cheng,
  • Yansong Zheng,
  • Jiahui Zhao

摘要

Background

The effect of arterial stiffness (AS) on incident chronic kidney disease (CKD) in healthy individuals remains unclear. In this study, we examined the relationship between AS, measured using brachial-ankle pulse wave velocity (baPWV), and cardiovascular-metabolic comorbidities in predicting CKD development.

Methods

This two-phase retrospective cohort study used data from the Chinese People’s Liberation Army General Hospital (2009–2021). The cross-sectional phase included 83,354 participants (77,711 without CKD and 5,643 with CKD), whereas the longitudinal phase included 13,738 participants. The association between baPWV and incident CKD was assessed using Cox regression analysis with restricted cubic splines, stratification, and mediation.

Results

CKD exhibited a prevalence of 6.77%. Participants with CKD had significantly higher baPWV than those without CKD. Compared to the reference category (< 1,400 cm/s), participants with baPWV ≥ 1,800 cm/s showed markedly increased odds of CKD development. Longitudinal analysis identified 403 incident CKD cases (2.93%) over a mean follow-up of 2.95 ± 2.02 years. A dose–response relationship was observed between baPWV and CKD development (p < 0.001), with the highest baPWV category conferring a 65% greater risk (p < 0.05). Mediation analysis showed significant indirect effects through systolic blood pressure (52.9%), diastolic blood pressure (45.1%), hyperlipidaemia (27.5%), and glycated haemoglobin (15.3%) (all p < 0.05).

Conclusions

Elevated baPWV values are associated with greater incident CKD risk, with blood pressure and glucose-lipid metabolism dysfunction potentially mediating this association. Further research is needed to determine whether interventions targeting AS and metabolic parameters reduce CKD incidence.