Reduced glomerular filtration rate due to loss of nephron mass may be an independent risk factor for atherosclerosis.
BACKGROUND
Whether living with reduced nephron mass (RNM) poses a risk to humans is the subject of ongoing controversy. The aim of this study was to discover whether or not RNMs are associated with greater atherosclerotic plaque burdens.


METHODS
Using the post-operative abdominal CT scans of 739 nephrectomized patients [NP; 315 women and 424 men; mean age 64.5 ± 15.0 years; observation period 4.9 ± 5.7 years (3675.9 patient-years)] and of an age- and a gender-matched control group, a retrospective observational and case-control study was conducted. The V600 calcium scoring method was used to determine the aortic calcium volume score (ACS) and thus the APB.


RESULTS
The ACS was 0.47 ± 0.77 mm(3) in the NPs compared with 0.41 ± 0.69 mm(3) in the control group (P <0.0001). The ACS and the glomerular filtration rate (GFR using the CKD-EPI formula) after nephrectomy correlated inversely (P = - 0.3652; P <0.0001), and the ACS and the time since nephrectomy correlated positively (P = 0.2919; P <0.0001). In linear regression models, age, time interval and GFR after nephrectomy proved to be independent factors of influence on ACS (P <0.05 each). Including the control group, age, GFR after nephrectomy and nephrectomy were independent factors of influence on the ACS. The factor GFR after nephrectomy explains ~ 10.7% in NPs, and 28% of the variance of the ACS in all patients.


CONCLUSIONS
The factors 'low GFR' and RNM are risk factors for greater atherosclerotic plaque burden. Patients with RNM should undergo regular control examinations to monitor arterial blood pressure and treat hypertension if it occurs.
Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
Bernhard
B
Glodny
Parinaz
P
Nasseri
Peter
P
Rehder
Verena
V
Unterholzner
Michaela
M
Plaikner
Christian
C
Koppelstätter
Johannes
J
Petersen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007223:Infant; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000601:surgery; D009392:Nephrectomy; D009399:Nephrons / Q000503:physiopathology*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014570:Urologic Diseases / Q000150:complications / Q000601:surgery; D055815:Young Adult