To assess the impact of arterial stiffness on prognosis in non-diabetic pre-dialysis patients with stages 3-5 chronic kidney disease (CKD) .

A total of 161 non-diabetic pre-dialysis patients who suffered from stages 3-5 CKD were enrolled in this study between April 2006 and November 2012. An automatic pulse wave velocity (PWV) measuring system was used to measure carotid-femoral PWV (CFPWV). According to CFPWV level, we divided the patients into a high CFPWV group (CFPWV≥12 m/s) and a normal group (CFPWV<12 m/s). The patients were followed for the occurrence of cardiovascular death and all-cause death. Kaplan-Meier method was used for survival analysis and Cox proportional hazard regression model was used to identify the risk factors.

The mean follow-up duration was (99.15±49.57) months. The incidence of cardiac-cerebralvascular death and all-cause death was significantly higher in the high CFPWV group than in the control group [37.6% (19/51) vs 11.0% (9/82), 50.7% (26/51) vs 20.7% (17/82), P<0.05]. Kaplan-Meier curve analysis for overall survival and cardiac-cerebral vascular event free survival showed that cardiac-cerebralvascular mortality and all-cause mortality were significantly higher in the high CFPWV group than in the control group (P<0.05). Multivariate Cox regression analysis revealed that increased CFPWV and age were the independent risk factors for cardiac-cerebralvascular mortality and all-cause mortality, and decreased albumin and hemoglobin were the independent risk factors for all-cause mortality (P<0.05).

The incidence of cardiac-cerebral vascular mortality and all-cause mortality is significantly higher in stages 3-5 CKD patients with elevated CFPWV than in those with normal CFPWV. Elevated CFPWV is one of independent risk factors for cardiac-cerebral vascular mortality and all-cause mortality in non-diabetic pre-dialysis patients with CKD.