Valeur predictive de l’étude de la vitesse de l’onde de pouls dans la détèction de la maladie rénale diabétique

Abstract

Diabetic kidney disease (DKD) is a major microangiopathic complication of type 2 diabetes (T2D) and is associated with substantial cardio-renal morbidity and mortality. The identification of non-invasive vascular biomarkers for the early detection of renal involvement remains a key clinical challenge. Pulse wave velocity (PWV), a surrogate of arterial stiffness, may represent a relevant marker of cardio-renal dysfunction. The aim of this study was to assess the predictive value of PWV for the detection of early DKD in patients with T2D. Methods: We conducted a retrospective, cross-sectional, multicenter study including 210 T2D patients divided into two groups: without DKD and with early DKD. Clinical, biological, metabolic, renal and cardiovascular parameters were collected, including carotid-femoral PWV measured by applanation tonometry. Statistical analyses included between-group comparisons, correlation analyses, multivariable logistic regression and ROC curve analysis. Results: Early DKD was identified in 51.4% of participants. Arterial stiffness was increased, with a mean PWV of 13.4 ± 3.61 m/s, and severe stiffness (>12 m/s) observed in 59% of subjects. Early DKD was significantly associated with diabetes duration, hypertension, history, sedentary lifestyle, inflammation, metabolic parameters and diabetic retinopathy. PWV was significantly higher in the DKD group and correlated with renal parameters (ACR, eGFR) as well as cardiometabolic factors. ROC curve analysis demonstrated the discriminative performance of PWV for DKD screening. Conclusion: PWV appears to be a non-invasive vascular biomarker associated with early DKD in patients with T2D. Its integration with classical renal markers such as ACR and eGFR could enhance early screening and cardio-renal risk stratification.