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Published on: February 7, 2015
Carotid intima-media thickness and atherosclerotic plaques are associated with renal function decline: a 14-year
Miriam Goepfert1, Till Ittermann2, Marcus Dörr3
1Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany.
Insights
Carotid intima-media thickness and plaques indicate declining kidney function and increased risk of chronic kidney disease (CKD). Atherosclerosis markers are linked to renal function decline in a population-based study.
Area of Science:
- Cardiovascular epidemiology
- Nephrology
- Medical imaging
Background:
- Chronic kidney disease (CKD) contributes significantly to morbidity and mortality.
- CKD shares common underlying causes with atherosclerosis.
- Investigated the link between carotid atherosclerosis and renal function decline.
Purpose of the Study:
- To determine if carotid atherosclerotic parameters are associated with renal function decline.
- To assess the relationship between carotid intima-media thickness (cIMT) and carotid plaques with changes in estimated glomerular filtration rate (eGFR) and the incidence of CKD.
Main Methods:
- Utilized data from the population-based Study of Health in Pomerania (SHIP) with 2904 subjects over 14 years.
- Measured cIMT and carotid plaques using B-mode ultrasound.
- Defined CKD as eGFR <60 mL/min/1.73 m2 and albuminuria (ACR ≥30 mg/g), calculating eGFR with FAS and CKD-EPI equations.
- Employed mixed models for longitudinal association analysis, adjusting for confounders.
Main Results:
- Subjects with high cIMT and carotid plaques showed a greater decrease in eGFR.
- High cIMT and plaques were associated with an increased risk of developing CKD during follow-up.
- No association was found between atherosclerotic parameters and the risk of developing albuminuria.
Conclusions:
- Carotid intima-media thickness and carotid plaques are significant predictors of renal function decline.
- These atherosclerotic markers are associated with an increased risk of developing CKD in a population-based sample.
- The Full Age Spectrum (FAS) equation demonstrated the best adaptation for eGFR calculation in this study population.
Background:
Chronic kidney disease (CKD) leads to increased morbidity and mortality. The underlying causes of CKD are often similar to those of atherosclerosis. We investigated whether carotid atherosclerotic parameters are associated with renal function decline.
Methods:
Within the population-based Study of Health in Pomerania (SHIP), Germany, 2904 subjects were observed over 14 years. The carotid intima-media thickness (cIMT) as well as carotid plaques were measured by standardized B-mode ultrasound protocol. CKD is defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and albuminuria as urinary albumin-creatinine ratio (ACR) ≥30 mg/g. eGFR was calculated by the full age spectrum (FAS) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Mixed models were applied to associate carotid parameters with change in renal function longitudinally and adjusted for confounding.
Results:
The age range of the study sample was 25-86 years with a median of 54 years at baseline. In longitudinal analyses, subjects with high cIMT and the presence of plaques at baseline showed a greater decrease in eGFR (cIMT: FAS-eGFR: P < .001, CKD-EPI-eGFR: P < .001; plaques: FAS-eGFR: P < .001, CKD-EPI-eGFR: n.s.) as well as an increased risk of developing CKD during the follow-up (cIMT: FAS-eGFR: P = .001, CKD-EPI-eGFR: P = .04; plaques: FAS-eGFR: P = .008, CKD-EPI-eGFR: P = .001). There was no association between atherosclerotic parameters and the risk of developing albuminuria.
Conclusions:
cIMT and carotid plaques are associated with renal function decline as well as CKD in a population-based sample. Furthermore, the FAS equation adapts best to this study population.
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