Type II Diabetes as the Main Risk Factor of Arterial Stiffness in Chronic Kidney Disease Patients

Chronic kidney disease (CKD) is frequently linked to an increased risk of cardiovascular disease. Diabetes, hypertension, dyslipidemia, and obesity are all traditional risk factors of cardiovascular disease in CKD. However, the contribution of each of the traditional risk factors to arterial stiffness is unknown. This was a correlational study with a cross-sectional design. This study included forty CKD patients from Universitas Airlangga Hospital Surabaya, between December 2019 until March 2020. Serum samples were used to measure laboratory parameters, and Doppler ultrasound was used to assess carotid-femoral Pulse Wave Velocity (cfPWV). Spearman's analysis was conducted to determine correlations between cf-PWV and e-GFR, HBA1C, serum creatinine, and cystatin-C. Mann-Whitney test was performed to determine the association between type II diabetes with cf-PWV. Significant results were continued with linear regression analysis model. There were significant correlations between cf-PWV and e-GFR, HBA1C, serum creatinine, and cystatin-C. HBA1C showed the most significant positive correlation with a moderate correlation coefficient (p = 0.000; r = 0.581). Patients with type II diabetes was associated with increased cf-PWV. Linear regression model also revealed that HBA1C and history of diabetes were significant predictors of increased cf-PWV in CKD patients (β= 0.400; p = 0.011 and β= 0.537; p = 0.000, respectively). We found a positive correlation between HBA1C and cf-PWV and association between type II diabetes and increased cf-PWV. This proved that type II diabetes, especially with high HBA1C, acted as a significant risk factor for predicting increased arterial stiffness in CKD patients.