Correlation between Carotid Intima-Media Thickness and Early-Stage Chronic Kidney Disease: Results from Asymptomatic Polyvascular Abnormalities in Community Study.
OBJECTIVE
Chronic kidney disease (CKD) might be a potential independent risk factor for increased carotid intima-media thickness (IMT). Our aim is to determine whether mild to moderate kidney dysfunction is associated with increased carotid IMT.


METHODS
We employed 3629 subjects free from clinical cardiovascular diseases at the baseline visit of the Asymptomatic Polyvascular Abnormalities in Community Study. Kidney function was evaluated in terms of estimated glomerular filtration rate (eGFR) calculated by the Chronic Kidney Disease Epidemiology Collaboration China equation. The mean of the maximal internal and common carotid IMT was measured by means of high-resolution B-mode ultrasound. Univariable linear regressions and multivariate logistic regressions were used to evaluate the independent association between kidney function and carotid IMT.


RESULTS
In the unadjusted linear analysis, carotid IMT showed a significant negative correlation with eGFR in both male (r = -.346, P < .001) and female (r = -.253, P < .001) subjects. After adjustment for age, traditional vascular risk factors (smoking, diabetes, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and antihypertensive drug use), and nontraditional risk factors (C-reactive protein and homocysteine), the association remained significant. The odds ratio for increased IMT was 1.299 (95% confidence interval [CI], 1.062-1.588) in the group with an eGFR of 60-89 mL/minute/1.73 m(2) and 1.789 (95% CI, 1.203-2.660) in the group with an eGFR of 30-59 mL/minute/1.73 m(2).


CONCLUSIONS
Increased IMT is associated with early-stage CKD. This association is independent of traditional and nontraditional cardiovascular risk factors. Early detection of kidney dysfunction is important to improve risk stratification of atherosclerotic disease.
Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yu
Y
Wu
Department of Nephrology, Kailuan Hospital, Hebei United University, Tangshan, China.
JinHong
J
Hou
Department of Nephrology, Kailuan Hospital, Hebei United University, Tangshan, China.
JunJuan
J
Li
Department of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China. Electronic address: luoyang96@163.com.
Yang
Y
Luo
Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China. Electronic address: drwusl@163.com.
ShouLing
S
Wu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging*; D012307:Risk Factors
Carotid intima–media thickness (IMT); atherosclerotic disease; chronic kidney disease (CKD); estimated glomerular filtration rate (eGFR)