Kidney volume associations with subclinical renal and cardiovascular disease: the Diabetes Heart Study.
BACKGROUND
The prognostic significance of total kidney volume (TKV) in subjects with type 2 diabetes mellitus (T2DM) is unknown.


METHODS
One hundred and seventy unrelated Caucasians with T2DM underwent multidetector-row computed tomography of the neck, chest, and abdomen to measure calcified plaque in the coronary artery (CorCP), carotid artery (CarCP), and infrarenal aorta (AorCP). Spearman's rank correlation coefficients were used to assess associations between TKV and subclinical renal and cardiovascular disease. Partial correlation coefficients were computed to adjust for the potential confounding effects of age, sex, body mass index, glomerular filtration rate (GFR), diabetes duration, and hemoglobin A(1c). Values are expressed as mean +/- SD (median in parentheses).


RESULTS
The study group (51% female) had a mean age of 62.9 +/- 8.5 (62.3) years, a T2DM duration of 11.5 +/- 6.8 (10.0) years, a urinary albumin:creatinine ratio of 109.9 +/- 396 (17.6) mg/g, a GFR of 63.8 +/- 12.8 (63.2) ml/min, a TKV of 272.4 +/- 69.7 (261.9) cm(3), CorCP 2,170 +/- 3,394 (653), CarCP 374 +/- 673 (104), AorCP 14,569 +/- 17,480 (8,370), and a carotid artery intima-media thickness of 0.70 +/- 0.14 (0.68) mm. Adjusting for age, sex, body mass index, diabetes duration, GFR, and hemoglobin A(1c), the TKV was significantly associated with AorCP (r = 0.20, p = 0.016), but not with CorCP, CarCP, or carotid artery intima-media thickness (all p >or= 0.25). No significant associations were detected between TKV and blood pressure or albuminuria.


CONCLUSIONS
In Caucasians with T2DM, TKV and calcified atherosclerotic plaque in the infrarenal abdominal aorta are positively associated. Common mechanisms linking renal matrix deposition with aortic atherosclerosis may underlie this association and require further study.
Department of Internal Medicine/Nephrology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1053, USA. asaran@wfubmc.edu
Anita M
AM
Saran
Fang-Chi
FC
Hsu
Kurt K
KK
Lohman
J Jeffrey
JJ
Carr
Donald W
DW
Bowden
Lynne E
LE
Wagenknecht
Barry I
BI
Freedman
D000368:Aged; D000419:Albuminuria / Q000473:pathology*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology; D001794:Blood Pressure / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000473:pathology; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D014057:Tomography, X-Ray Computed