title: Association between glomerular filtration rate and endothelial function in an elderly community cohort.
abstract: BACKGROUND
  Endothelial dysfunction is prevalent among individuals with chronic kidney disease. However, the association between glomerular filtration rate and endothelial function in the community is unclear and needs to be investigated in the general population.
  
  
  METHODS
  In the community-based Prospective Investigation of the Vasculature of Uppsala Seniors study (PIVUS, n = 952, mean age 70, women 49.3%), we investigated cross-sectional associations between estimated cystatin C-based glomerular filtration rate (eGFR), and 3 measures representing different aspects of endothelial function (endothelial-dependent vasodilation [EDV], endothelial independent vasodilatation [EIDV], and flow-mediated dilatation [FMD]). We also performed pre-specified sub-group analyses in participants with normal eGFR (>60 ml/min/1.73 m(2)).
  
  
  RESULTS
  In the whole cohort, 10 ml/min/1.73 m(2) higher eGFR was associated with 3% higher EDV (p = 0.001) and 2% higher EIDV (p = 0.007), adjusted for age and sex. The associations were attenuated and no longer statistically significant after adjusting for established cardiovascular risk factors. In participants with eGFR >60 ml/min/1.73 m(2), 10 ml higher eGFR was associated with 2% higher EDV (p = 0.04) after adjusting for sex and age. eGFR was not associated to FMD in any model or sub-sample.
  
  
  CONCLUSIONS
  This community-based study suggests that eGFR is associated with endothelial function also in persons with normal kidney function, but that this association is largely explained by confounding by established cardiovascular risk factors. Thus, our data do not support the notion of a direct causal interplay between renal and vascular function prior to the development of CKD.
authors: Department of Public Health and Caring Sciences/Geriatrics, Uppsala Science Park, SE-751 85 Uppsala, Sweden. ene@du.se
authors: Elisabet
authors: E
authors: Nerpin
authors: Erik
authors: E
authors: Ingelsson
authors: Ulf
authors: U
authors: Risérus
authors: Johanna
authors: J
authors: Helmersson-Karlqvist
authors: Johan
authors: J
authors: Sundström
authors: Elisabeth
authors: E
authors: Jobs
authors: Anders
authors: A
authors: Larsson
authors: Lars
authors: L
authors: Lind
authors: Johan
authors: J
authors: Ärnlöv
mesh_terms: D000368:Aged; D015331:Cohort Studies; D055316:Cystatin C; D004730:Endothelium, Vascular / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000503:physiopathology; D014664:Vasodilation / Q000502:physiology
chemical_list: D055316:Cystatin C