International Journal of Medical Sciences

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15 December 2017

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Int J Med Sci 2015; 12(7):530-537. doi:10.7150/ijms.12164

Research Paper

Compliance Index, a Marker of Peripheral Arterial Stiffness, may Predict Renal Function Decline in Patients with Chronic Kidney Disease

Te-Hui Kuo1*, Deng-Chi Yang2*, Wei-Hung Lin3,4, Chin-Chung Tseng1, Ju-Yi Chen5, Chin-Shan Ho6, Meng-Fu Cheng1, Wei-Chuan Tsai5✉, Ming-Cheng Wang1,7✉

1. Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
2. Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
3. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
4. Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
5. Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
6. Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
7. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
* Dr. Te-Hui Kuo and Deng-Chi Yang contributed equally to this work.

Abstract

Background: Compliance index derived from digital volume pulse (CI-DVP), measuring the relationship between volume and pressure changes in fingertip, is a surrogate marker of peripheral arterial stiffness. This study investigated if CI-DVP can predict renal function deterioration, cardiovascular events and mortality in patients with chronic kidney disease (CKD).

Methods: In this prospective observational study, 149 CKD patients were included for final analysis. CI-DVP and brachial-ankle pulse wave velocity (baPWV) were measured, decline in renal function was assessed by the estimated glomerular filtration rate (eGFR) slope. Composite renal and cardiovascular outcomes were evaluated, including ≥50% eGFR decline, start of renal replacement therapy, and major adverse events.

Results: Patients in CKD stages 3b to 5 had higher baPWV and lower CI-DVP values than those in patients with CKD stages 1 to 3a. Stepwise multivariate linear regression analysis showed that lower CI-DVP (p =0.0001) and greater proteinuria (p =0.0023) were independent determinants of higher eGFR decline rate. Multivariate Cox regression analysis revealed that CI-DVP (HR 0.68, 95% CI 0.46-1.00), baseline eGFR (HR 0.96, 95% CI 0.94-0.98) and serum albumin (HR 0.17, 95% CI 0.07-0.42) were independent predictors for composite renal and cardiovascular outcomes.

Conclusions: Compliance index, CI-DVP, was significantly associated with renal function decline in patients with CKD. A higher CI-DVP may have independent prognostic value in slower renal function decline and better composite renal and cardiovascular outcomes in CKD patients.

Keywords: Arterial stiffness, Chronic kidney disease, Compliance index, Glomerular filtration rate, Major adverse event

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Kuo TH, Yang DC, Lin WH, Tseng CC, Chen JY, Ho CS, Cheng MF, Tsai WC, Wang MC. Compliance Index, a Marker of Peripheral Arterial Stiffness, may Predict Renal Function Decline in Patients with Chronic Kidney Disease. Int J Med Sci 2015; 12(7):530-537. doi:10.7150/ijms.12164. Available from http://www.medsci.org/v12p0530.htm