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Updated: Jun 26, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Renal Dysfunction Increases Risk of Adverse Cardiovascular Events in 5-Year Follow-Up Study of Intermediate Coronary
Piotr Baruś1, Jaromir Hunia1, Rafał Kaczorowski1
1First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Insights
Mild-to-moderate chronic kidney disease (CKD) did not alter coronary plaque characteristics or lesion severity in intermediate coronary artery lesions. However, CKD patients faced higher risks of mortality and major adverse cardiovascular events over five years.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Chronic coronary syndrome (CCS) progression is linked to chronic kidney disease (CKD).
- Understanding the impact of renal function on coronary artery lesions is crucial for patient outcomes.
Purpose of the Study:
- To evaluate how mild-to-moderate renal dysfunction affects intermediate coronary artery lesions.
- To assess the 5-year outcomes of patients with varying renal function.
Main Methods:
- Prospective study of 100 patients with intermediate coronary stenosis.
- Lesions evaluated using optical coherence tomography (OCT), fractional flow reserve (FFR), and intravascular ultrasound (IVUS).
- Patients stratified into groups based on estimated glomerular filtration rate (eGFR).
Main Results:
- No significant differences in plaque morphology or lesion severity between renal dysfunction groups.
- Patients with mild-to-moderate renal dysfunction were older.
- Elevated risk of all-cause mortality and major adverse cardiovascular events observed in patients with renal dysfunction over 5 years.
Conclusions:
- Mild-to-moderate renal dysfunction does not significantly alter intermediate coronary stenosis characteristics (plaque morphology, FFR, IVUS).
- Renal dysfunction is associated with increased long-term risk of mortality and major adverse cardiovascular events.
- Further research is needed to explore the mechanisms linking CKD to adverse cardiovascular outcomes.
Abstract:
BACKGROUND Progression of chronic coronary syndrome (CCS) is influenced by chronic kidney disease (CKD). This 5-year follow-up study aimed to assess 100 patients with 118 intermediate coronary artery lesions evaluated by fractional flow reserve (FFR) and intravascular imaging stratified according to renal function. MATERIAL AND METHODS This prospective study enrolled patients with intermediate coronary stenosis identified by coronary angiogram. Patients with severe renal dysfunction (estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m²) were excluded from the study. The remaining were divided into 2 groups according to eGFR: 45-60 ml/min/1.73 m² for mild-to-moderate renal dysfunction and >60 ml/min/1.73 m² for no renal dysfunction. We analyzed intermediate-grade stenoses (40-80% as assessed in coronary angiography) with the use of optical coherence tomography (OCT), FFR, and intravascular ultrasound (IVUS). RESULTS Renal dysfunction patients were older (67.7±8.1 vs 63.6±9.7 years, P=0.044). Lesion characteristics, including plaque type and minimal lumen area in OCT, showed no significant differences between the renal dysfunction and no renal dysfunction groups. Thin-cap fibroatheroma, calcific plaques, lipidic plaques, and fibrous plaques had similar prevalence. FFR values and IVUS parameters did not significantly differ between the groups. Over a 5-year follow-up, individuals with mild-to-moderate renal dysfunction had an elevated risk of all-cause mortality and major adverse cardiovascular events in multivariate analyses adjusted for age and sex. CONCLUSIONS Mild-to-moderate renal dysfunction was not associated with significant differences in OCT- and IVUS-derived plaque morphology nor with functional indices characterizing intermediate-grade coronary stenoses. Renal dysfunction was related to a higher risk of all-cause mortality and major adverse cardiovascular events prevalence in 5-year follow-up.
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