#3490 Serum acrolein as a potential biomarker of aortic stiffness in patients with non-dialysis chronic kidney disease stage 3 to 5

Abstract Background and Aims Acrolein, a reactive aldehyde found in environmental pollutants and generated endogenously, has been associated with increased cardiovascular disease risk. Aortic stiffness predicts cardiovascular disease and is associated with aging-associated vascular diseases. The study aimed to investigate the correlation between serum acrolein level and aortic stiffness measured by cfPWV values in patients with chronic kidney disease (CKD) stage 3 to 5. Method Fasting blood samples and baseline characteristics were obtained from 204 CKD stage 3 to 5 patients. Commercially available enzyme-linked immunosorbent assays determined serum acrolein levels. cfPWV was measured using the SphygmoCor system. Patients with carotid-femoral pulse wave velocity (cfPWV) >10 m/s were defined as the aortic stiffness group. Results Among 204 CKD patients, 69 (33.8%) were in the aortic stiffness group. When compared to those in the control group, the aortic stiffness group had a high prevalence of diabetes mellitus (DM, P = 0.002), hypertension (P = 0.001), older age (P = 0.018), higher systolic blood pressure (SBP, P < 0.001), diastolic blood pressure (DBP, P < 0.001), serum fasting glucose (P = 0.001), triglyceride (P = 0.012), blood urea nitrogen (BUN, P = 0.013), creatinine (P = 0.011), acrolein level (P < 0.001), urine protein–creatinine ratio (UPCR, P < 0.001), while lower in estimated glomerular filtration rate (eGFR, P = 0.013). Multivariate logistic regression analysis of the factors significantly associated with aortic stiffness revealed that serum acrolein levels (odds ratio (OR): 1.013, 95% confidence interval (CI): 1.000–1.026, P = 0.048) were the independent predictors of aortic stiffness in CKD patients. By Spearman correlation analysis, logarithmically transformed acrolein (log-acrolein) levels were significantly positively correlated with age (P = 0.048), SBP (P < 0.001), DBP (P < 0.001), cfPWV (P < 0.001), log-BUN (P < 0.001), log-creatinine (P < 0.001), and log-UPCR levels (P = 0.004) and negatively correlated with eGFR (P < 0.001) and hemoglobin (P = 0.007). The area under the receiver-operating characteristic curve for serum acrolein was 0.719 (95% CI: 0.641–0.798, P < 0.001) to predict the development of aortic stiffness in patients with CKD stage 3 to 5. Conclusion Serum acrolein level is an independent marker of aortic stiffness and is positively associated with cfPWV values in patients with CKD stage 3 to 5.