title: Association between chronic kidney disease and carotid intima-media thickening in individuals with hypertension and impaired glucose metabolism.
abstract: We investigated whether chronic kidney disease (CKD) was associated with carotid intima-media thickening in 1,351 male individuals undergoing general health screening. Glomerular filtration rate (GFR) was estimated by the Modification of Diet in Renal Disease equations using 0.881 as a coefficient for Japanese, and low estimated GFR (eGFR) was defined as an eGFR value of <60 mL/min/1.73 m(2). Albuminuria was defined as a urine albumin-to-urine creatinine ratio of >or=30 mg/g, and CKD was defined when low eGFR and/or albuminuria was present. After adjusting for age, CKD was associated with carotid intima-media thickening with an odds ratio of 1.47 (95% confidence interval [CI] 1.05-2.06, p=0.0024). After adjusting for age, fasting plasma glucose, and smoking status, both albuminuria and low eGFR were significantly associated with intima-media thickening in individuals with hypertension with an odds ratio of 1.85 (95% CI 1.13-3.03, p=0.015) and 1.79 (95% CI 1.09-2.94, p=0.022), respectively. On the other hand, neither of them was associated with carotid intima-media thickening in individuals without hypertension. Similarly, after adjusting for age, systolic blood pressure, and smoking status, both albuminuria and low eGFR were significantly associated with intima-media thickening in individuals with high fasting glucose (defined as fasting plasma glucose levels of >or=110 mg/dL or current use of anti-diabetic medication), but not in those without. Our data indicate that CKD or its components (low eGFR and albuminuria) may be associated with early carotid atherosclerosis in low-risk individuals, such as those undergoing general health screening, who have hypertension and/or impaired glucose metabolism.
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan. nobuishizka-tky@umin.ac.jp
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishizaka
authors.forename: Ei-Ichi
authors.initials: E
authors.lastname: Toda
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: George
authors.initials: G
authors.lastname: Seki
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamakado
mesh_terms: D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000209:etiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005919:Glomerular Filtration Rate; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*
chemical_list: D005947:Glucose