Glomerular Filtration Rate (Gfr) And Urinary Albumin Excretion (Uae) Correlates With Arterial Stiffness In Hypertensive And Diabetic Subjects

Background and Aims: Diabetic nephropathy is the main cause of chronic renal failure in western countries. The evidence that increased arterial stiffness is associated with cardiovascular morbidity and mortality, has been supported by the European Society of Cardiology guidelines, to use, when possible as a further measure of cardiovascular risk. The objective of the present study was to assess the relationship between GFR and UAE with several arterial stiffness markers measured by applanation tonometry in those hypertensive and diabetic subjects. Subjects and Methods: 37 subjects with essential hypertension and diabetes mellitus type II were included, 65.3 ± 10.9 years old (61% male). Right radial artery applanation tonometry was used to derive central systolic (cSBP) and diastolic BP (cDBP), central pulse pressure (cPP), augmentation pressure (AP) or the difference between the first and the second systolic peaks and finally augmentation index (AP/cPP ratio expressed as a percentage) normalized for a heart rate of 75 beats per minute (AIx75). Carotid-radial pulse wave velocity (PWV) was also measured as an index of aortic stiffness. Central arterial waveforms and PWV were derived by using the At Cor Medical device (Sphygmo Cor Px®, Vx®, Sidney, Australia) wich uses a validated transfer function. Clinical assessment, blood and 24-hour urine samples were analysed at the beginning to determine UAE and Cockcroft-Gault equation to determine GFR. Results: Mean GFR was 77 ml/min/1.73 m2, mean UAE was 14.8 mg/24 hour. Mean cSBP/DBP were 137/79 mmHg and cPP was 57.9 ± 19.7 mmHg. Mean AP was 15.2 ± 7.4 mmHg and mean AIx75 was 25.6% ± 8.9%. Mean PWV was 8.69 m/sec ± 1 m/sec. GFR correlates with cDBP (r: 354; p: 0.031) and UAE correlates with PWV (r: 0.691; p: 0.039). Conclusions: GFR correlates with cDBP and UAE correlates with PWV in those hypertensive subjects with diabetes mellitus. Increased arterial stiffness in diabetic subjects may be related to impaired renal function.