title: Renal function and carotid atherosclerosis in adults with no known kidney disease.
abstract: OBJECTIVE
  A high prevalence of atherosclerotic lesions characterizes patients with chronic kidney disease, though there is little data on the relationship between kidney function and atherosclerotic changes in the healthy population or in people with no known renal impairment. The aim of our study was to analyze, in a comprehensive general population with no known kidney disease, the relationship between renal function and subclinical carotid atherosclerotic damage.
  
  
  RESULTS
  A general real-life population of 611 participants (233 males and 378 females; age ≥18 years) with no known kidney failure was selected for the study. The glomerular filtration rate (GFR) was estimated according to the CKD-EPI equation. Carotid intima-media thickness (c-IMT) and plaques were assessed by duplex Doppler ultrasonography of the carotid vessels. The main laboratory and metabolic parameters were evaluated in all participants. When we divided the overall study population into tertiles according to GFR values (I tertile <85; II tertile: 85-99; III tertile >99 ml/min/1.73 m2), the c-IMT mean values and the prevalence of carotid plaques decreased with the increasing tertile of GFR. On univariate analysis, c-IMT was significantly correlated with eGFR (r = -0.33; p < 0.001), serum creatinine (r = 0.17; p < 0.001), and other variables such as age, systolic blood pressure, waist circumference, fasting or random glycemia, and glycated hemoglobin (HbA1c). On multiple regression analysis, serum creatinine was associated with c-IMT (β = 0.069; p = 0.017), independent of other covariates.
  
  
  CONCLUSIONS
  Our study seems to suggest the importance of early identification of people with near normal or mildly decreased renal function due to its association with carotid atherosclerosis.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy; Laboratorio di Metabolismo e Nutrizione Clinica, University of Palermo, Italy. Electronic address: silbus@tin.it.
authors.forename: S
authors.initials: S
authors.lastname: Buscemi
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Geraci
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, University of Palermo, Italy.
authors.forename: F M
authors.initials: FM
authors.lastname: Massenti
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy; Laboratorio di Metabolismo e Nutrizione Clinica, University of Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Buscemi
authors.affiliation: Servizio di Ingegneria Clinica, Policlinico "P. Giaccone", Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Costa
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy; Laboratorio di Metabolismo e Nutrizione Clinica, University of Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: D'Orio
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy; Laboratorio di Metabolismo e Nutrizione Clinica, University of Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rosafio
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy; Laboratorio di Metabolismo e Nutrizione Clinica, University of Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Buscemi
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy; Laboratorio di Metabolismo e Nutrizione Clinica, University of Palermo, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Maniaci
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Parrinello
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex
keywords: Carotid atherosclerosis; Carotid intima-media thickness; Carotid plaques; Glomerular filtration rate