Abstract
Background：Effective interventions to prevent or mitigate arterial stiffness in patients with pre—
dialysis chronic kidney disease（CKD）have not been fully established. Therefore, it is essential to elucidate
potential factors associated with arterial stiffness.
Objective：This study aimed to examine factors associated with arterial stiffness in patients with
pre—dialysis CKD by considering skeletal muscle mass and physical function in addition to patient characteristics
and renal function. Furthermore, we explored these associations by sex.
Methods：This cross—sectional study included 62 patients with pre—dialysis CKD（37 men, 25
women）hospitalized for CKD education. Arterial stiffness was assessed using the cardio—ankle vascular
index（CAVI）. Skeletal muscle mass was evaluated using the skeletal muscle mass index（SMI）, while
physical function was assessed via handgrip strength, the Short Physical Performance Battery, and the
6—minute walk distance.
Results：A total of 38 patients（61.3％）had a CAVI of ≥9.0. Multiple regression analysis with CAVI
as the dependent variable revealed that smoking history was significantly associated with CAVI in the
total sample（β＝0.41, p＜0.05）and in women（β＝0.82, p＜0.05）. In men, SMI was significantly associated
with CAVI（β＝—0.54, p＜0.05）.
Conclusion：Factors associated with arterial stiffness in patients with pre—dialysis CKD may differ
by sex. In particular, skeletal muscle mass appeared to be more strongly associated with CAVI in men.
