title: Relation of albuminuria to coronary microvascular function in patients with chronic kidney disease.
abstract: The relation between albuminuria and coronary microvascular function in patients with chronic kidney disease (CKD) has not been fully investigated. Therefore, we sought to assess whether albuminuria is associated with coronary flow velocity reserve (CFVR) impairment in patients with CKD. Coronary flow study was prospectively performed in 175 patients with CKD. CFVR of the left anterior descending artery was measured to evaluate coronary microvascular function using transthoracic echocardiography. We divided the patients into 5 groups according to the stages of CKD and analyzed the effect of albuminuria. CFVR gradually decreased with an increase in CKD stages. CFVR in patients with albuminuria was lower than those without albuminuria. In groups with CKD stages 2 and 3, the patients with albuminuria showed lower CFVR than those without albuminuria. Multiple logistic regression analysis revealed that albuminuria, age, and gender were independently associated with CFVR impairment. Of these factors, albuminuria was the most powerful predictor with the risk ratio of 12.4 for CFVR impairment. In conclusion, the more the CKD stages progressed, the more severe CFVR was impaired. Albuminuria was associated with CFVR impairment in patients with CKD; even in mild-to-moderate CKD, patients with albuminuria showed further reduced coronary vasodilator capacity.
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Sari
authors.initials: S
authors.lastname: Imamura
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan. Electronic address: hiratakumiko@aol.com.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Orii
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shimamura
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Shiono
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamano
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.affiliation: Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D015897:Comorbidity; D003326:Coronary Circulation / Q000502:physiology*; D018618:Echocardiography, Doppler, Color; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000503:physiopathology*