Related Experiment Video
Updated: Apr 15, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Kidney function, endothelial activation and atherosclerosis in black and white Africans with rheumatoid arthritis
Patrick H Dessein1, Hon-Chun Hsu2, Linda Tsang1
1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Reduced kidney function is linked to atherosclerosis in Black and White Africans with rheumatoid arthritis (RA). Chronic kidney disease (CKD) is common in Black RA patients, and estimated glomerular filtration rate (eGFR) equations help predict cardiovascular risk.
Area of Science:
- Nephrology
- Cardiology
- Rheumatology
Background:
- Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
- Endothelial dysfunction and atherosclerosis are key mechanisms contributing to CVD in RA.
- Kidney function may play a role in the development of atherosclerosis in RA patients.
Purpose of the Study:
- To investigate the independent relationship between kidney function and endothelial activation.
- To assess the association between kidney function and carotid atherosclerosis in Black and White Africans with RA.
- To evaluate the predictive value of different estimated glomerular filtration rate (eGFR) equations for carotid plaque.
Main Methods:
- Recruited 233 RA patients (112 Black).
- Calculated eGFR using Jelliffe, Cockcroft-Gault, Salazar-Corcoran, MDRD, and CKD-EPI equations.
- Assessed endothelial activation markers and carotid atherosclerosis via ultrasound (intima-media thickness and plaque).
Main Results:
- Reduced eGFR (<90 ml/min/1.73m2) was more prevalent in Black (49.1%) than White (30.6%) RA patients.
- eGFR correlated with endothelial markers in White patients and carotid plaque in Black patients.
- eGFR equations, except MDRD, effectively predicted carotid plaque in Black RA patients, with low eGFR increasing plaque odds 2.2-4.0 fold.
Conclusions:
- Reduced kidney function is an independent risk factor for atherosclerosis and endothelial activation in RA patients of African descent.
- Chronic kidney disease (CKD) is highly prevalent among Black Africans with RA.
- eGFR equations are valuable tools for predicting cardiovascular risk in Black African RA patients.
Objective:
To determine whether kidney function independently relates to endothelial activation and ultrasound determined carotid atherosclerosis in black and white Africans with rheumatoid arthritis (RA).
Methods:
We calculated the Jelliffe, 5 Cockcroft-Gault equations, Salazar-Corcoran, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (EGFR) equations in 233 (112 black) RA patients.
Results:
The CKD-EPI eGFR was <90 ml/min/1.73m2 in 49.1% and 30.6% of black and white patients, respectively (odds ratio (95% confidence interval) = 2.19 (1.28-3.75), p = 0.004). EGFRs were overall consistently associated with monocyte chemoattractant protein-1 and angiopoietin 2 concentrations in white patients, and with carotid intima-media thickness and plaque in black participants. Amongst black patients, plaque prevalence was 36.7% and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was not associated with plaque presence for the MDRD equation (p = 0.3), whereas the respective relationship was significant or borderline significant (p = 0.003 to 0.08) and of similar extent (p>0.1 for comparisons of AUC (SE)) for the other 8 equations. Based on optimal eGFR cutoff values with sensitivities and specificities ranging from 42 to 60% and 70 to 91% respectively, as determined in ROC curve analysis, a low eGFR increased the odds ratio for plaque 2.2 to 4.0 fold.
Conclusion:
Reduced kidney function is independently associated with atherosclerosis and endothelial activation in black and white Africans with RA, respectively. CKD is highly prevalent in black Africans with RA. Apart from the MDRD, eGFR equations are useful in predicting carotid plaque presence, a coronary heart disease equivalent, amongst black African RA patients.
More Related Videos
08:21A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
08:15Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease
Published on: May 10, 2024
