Progression of Renal Disease and Arterial Stiffening in Type II Diabetes Mellitus

Background: Type II Diabetes Mellitus has long been known to cause vasculopathy of both small and large vessels resulting in functional decline of vital organs especially the kidneys. Renal function of diabetics gradually declines with disease progression and can be assessed by determining the estimated glomerular filtration rate (eGFR). The effects of Diabetes on the vasculature can also be quantified by determining the degree of arterial stiffness in peripheral blood vessels such as the brachial or femoral arteries, using measured pulse wave velocity (PWV) as the assessment tool. Objective: In this study we attempt to evaluate the correlation between arterial stiffness and chronic kidney disease (CKD) stage in Type II diabetics. Methods: Subjects were diabetic patients diagnosed within the past 8 years, within the ages of 40-70 with an HbA1c between 6-9% being treated only with metformin. Once enrolled in the study each patient had blood drawn to calculate eGFR, and PWV of the femoral artery was measured using SphygmoCor CP system from ATCOR. Results: Comparing PWV between the two groups of patients with earlier stage CKD vs. stage 2 demonstrated that higher PWV are seen in the group with stage 2 CKD. The median PWV in patients with stage 1 CKD were 8.5 vs. 10.75 in the stage 2 CKD group. Conclusions: Our data supports the hypothesis that there is an association between increasing arterial stiffness and progression of CKD in Type II diabetics. This data suggests that perhaps the mechanism underlying the development of macrovascular complications of larger blood vessels in diabetes may also contribute to the development of the microvascular complication of renal disease