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BioMed Research International
Volume 2013, Article ID 309294, 10 pages
http://dx.doi.org/10.1155/2013/309294
Research Article

Peripheral Arterial Stiffness Is Independently Associated with a Rapid Decline in Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes

1Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital, Department of Health, Executive Yuan, No. 199, Section 1, Sanmin Road, Taichung 402, Taiwan
2Institute of Biostatistics, China Medical University, No. 91 Hsueh-Shih Road, Taichung 404, Taiwan
3Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Taichung 407, Taiwan
4School of Medicine, National Defense Medical Center, Taipei, Taiwan
5School of Medicine, National Yang-Ming University, Taipei, Taiwan
6Institute of Medical Technology, National Chung-Hsing University, Taichung, Taiwan

Received 22 September 2013; Revised 16 November 2013; Accepted 23 November 2013

Academic Editor: Vecihi Batuman

Copyright © 2013 Yi-Jing Sheen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Diabetes and its vascular complications are main noncommunicable chronic diseases and major global health issues. Peripheral arterial disease (PAD) is highly prevalent in diabetes with nephropathy. We evaluated the associations of variables of arterial stiffness and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes. Materials and Methods. A total of 577 type 2 diabetic patients (mea : age, years) were enrolled. A rapid decline in eGFR was defined as progressively lower eGFR detected at both the 6- and 12-month follow-up visits, plus a reduction in eGFR more than 3 mL min−1per 1.73 m2 per year. Results. Higher glycated hemoglobin (HbA1c), systolic blood pressure (SBP), pulse pressure (PP), and brachial-ankle pulse wave velocity (ba-PWV) at baseline were independently associated with a rapid decline in eGFR. The adjusted odds ratios (95% confidence intervals) for a rapid decline in eGFR for ba-PWV, SBP, and PP were 1.072 (1.011–1.136), 1.014 (1.004–1.025), and 1.025 (1.008–1.041), respectively, after adjustment for gender, age, body mass index, smoking, HbA1c, and baseline eGFR in separated models. Conclusions. Ba-PWV may serve as a simple and noninvasive predictor of rapid renal function progression in type 2 diabetic patients.