Objective: The aim of this study was to evaluate the association between arterial stiffness and albuminuria and glomerular filtration rate (GFR) in patients with type 2 diabetic nephropathy.
Methods: This multicenter cohort study analyzed 2,613 patients with type 2 diabetes who were recruited from eight general hospitals in Korea. Brachialankle pulse wave velocity (baPWV) was used as a noninvasive marker of arterial stiffness. Additionally, the patients were categorized into four groups according to their albumin-to-creatinine ratio (ACR; normoalbuminuria vs. albuminuria) and estimated GFR (eGFR, < 60 mL/min/1.73m2 vs. ≥ 60 mL/min/1.73m2).
Results: A univariate analysis of the entire subject pool revealed that maximal baPWV was significantly correlated with both the ACR (r = 0.302, P < 0.001) and eGFR (r = -0.218, P < 0.001). A multivariate analysis adjusted for significant clinical variables and eGFR showed that baPWV remained significantly associated with the ACR (r = 0.226, P < 0.001). Also, baPWV was correlated positively with the ACR in patients with an eGFR ≥ 60 mL/min/1.73m2 (r = 0.219, P < 0.001); however, baPWV was not correlated with eGFR after adjustment for significant clinical variables. In addition, the multivariate model revealed that an increase in baPWV was not associated with a decrease in eGFR in normoalbuminuric patients.
Conclusion: The present findings indicate that arterial stiffness is more associated with albuminuria than is a decrease in GFR in patients with type 2 diabetic nephropathy. In particular, arterial stiffness was not associated with normoalbuminuric CKD in patients with type 2 diabetes.