title: Relations of measures of endothelial function and kidney disease: the Framingham Heart Study.
abstract: BACKGROUND
  Endothelial dysfunction is prevalent in individuals with end-stage renal disease. Whether endothelial dysfunction is present in patients with moderate chronic kidney disease (CKD) is uncertain.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Brachial reactivity measurements were obtained during the seventh examination cycle in 2,818 (diameter measurements) and 2,256 (flow measurements) Framingham Heart Study Offspring cohort participants (53% women; mean age, 61 +/- 9 years).
  
  
  METHODS
  Estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) derived from creatinine- and cystatin C-based estimating equations; microalbuminuria status.
  
  
  RESULTS
  Brachial reactivity measurements (baseline brachial diameter, flow-mediated dilation, baseline and hyperemic mean flow).
  
  
  METHODS
  Linear regression models were used to model brachial measures as a function of CKD and microalbuminuria status.
  
  
  RESULTS
  Overall, 7.3% (n = 206) of participants had CKD, and of 2,301 with urinary measurements, 10.0% (n = 230) had microalbuminuria. Brachial reactivity measures did not differ significantly by CKD status in either creatinine- or cystatin C-based equations in either age- and sex- or multivariable-adjusted models. In age- and sex-adjusted models, microalbuminuria was associated with decreased hyperemic mean flow (47.2 +/- 1.4 versus 51.4 +/- 0.5 mg/g; P = 0.005), but the association was not significant after multivariable adjustment (P = 0.09).
  
  
  CONCLUSIONS
  Predominantly white ambulatory cohort; results may not be generalizable to other ethnic groups or individuals with severe CKD.
  
  
  CONCLUSIONS
  Endothelial dysfunction was not a major correlate of CKD in our sample.
authors.affiliation: The National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA 01702, USA.
authors.forename: Meredith C
authors.initials: MC
authors.lastname: Foster
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Keyes
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Vita
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged