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Kidney function and progression of carotid intima-media thickness in a community study.
Am J Kidney Dis. 2008 Apr; 51(4):584-93.AJ

Abstract

BACKGROUND

Limited data exist regarding the relationship between decreased kidney function, carotid intima-media thickness (IMT) progression, and vascular events.

STUDY DESIGN

A community-based cohort study.

SETTING & PARTICIPANTS

3,364 participants in the Intervention Project on Cerebrovascular Diseases and Dementia in the Community of Ebersberg, Bavaria Study.

PREDICTOR

Quartiles of kidney function level estimated by means of creatinine clearance (Ccr) using the Cockcroft-Gault equation (Ccr <64, 64 to 75, 75 to 89, and >89 mL/min/1.73 m(2)).

OUTCOMES & MEASUREMENTS

Change in carotid IMT during 2 years. Composite clinical study end point is the occurrence of major adverse cardiovascular events, a composite of myocardial infarction, stroke, and vascular death after 2 years.

RESULTS

Baseline mean carotid IMT was 0.79 +/- 0.19 (SD) mm. Mean change in carotid IMT was 0.02 +/- 0.11 mm/y. Lower Ccr quartile at baseline was associated with a greater change in adjusted mean values: 0.024 (95% confidence interval [CI], 0.020 to 0.027); 0.019 (95% CI, 0.015 to 0.023); 0.012 (95% CI, 0.009 to 0.016); and 0.0077 (95% CI, 0.005 to 0.011), respectively (P < 0.01). After evaluation of change in carotid IMT, 36 patients (1.1%) experienced a fatal and nonfatal vascular event. Subjects with baseline Ccr less than the median (75 mL/min/1.73 m(2)) and change in carotid IMT greater than the median (0.008 mm/y) had the worst prognosis (log-rank test, P = 0.04). By means of multivariable analysis with the Cox proportional hazard model, lower baseline Ccr (hazard ratio, 1.04; 95% CI, 1.02 to 1.23; P = 0.03 per 1-mL/min/1.73 m(2) decrease) and faster change in carotid IMT (hazard ratio, 1.15; 95% CI, 1.11 to 1.93; P = 0.01 per 0.1-mm increase) were associated with fatal and nonfatal vascular events.

LIMITATIONS

Microalbuminuria, associated with carotid atherosclerosis, was not available.

CONCLUSION

Decreased kidney function is associated strongly with faster change in carotid IMT. In addition, decreased kidney function and faster change in carotid IMT are associated with cardiovascular events.

Authors+Show Affiliations

Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80262, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18371534

Citation

Desbien, Angela M., et al. "Kidney Function and Progression of Carotid Intima-media Thickness in a Community Study." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 51, no. 4, 2008, pp. 584-93.
Desbien AM, Chonchol M, Gnahn H, et al. Kidney function and progression of carotid intima-media thickness in a community study. Am J Kidney Dis. 2008;51(4):584-93.
Desbien, A. M., Chonchol, M., Gnahn, H., & Sander, D. (2008). Kidney function and progression of carotid intima-media thickness in a community study. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 51(4), 584-93. https://doi.org/10.1053/j.ajkd.2007.11.026
Desbien AM, et al. Kidney Function and Progression of Carotid Intima-media Thickness in a Community Study. Am J Kidney Dis. 2008;51(4):584-93. PubMed PMID: 18371534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kidney function and progression of carotid intima-media thickness in a community study. AU - Desbien,Angela M, AU - Chonchol,Michel, AU - Gnahn,Hannes, AU - Sander,Dirk, Y1 - 2008/03/03/ PY - 2007/06/15/received PY - 2007/11/28/accepted PY - 2008/3/29/pubmed PY - 2008/5/29/medline PY - 2008/3/29/entrez SP - 584 EP - 93 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 51 IS - 4 N2 - BACKGROUND: Limited data exist regarding the relationship between decreased kidney function, carotid intima-media thickness (IMT) progression, and vascular events. STUDY DESIGN: A community-based cohort study. SETTING & PARTICIPANTS: 3,364 participants in the Intervention Project on Cerebrovascular Diseases and Dementia in the Community of Ebersberg, Bavaria Study. PREDICTOR: Quartiles of kidney function level estimated by means of creatinine clearance (Ccr) using the Cockcroft-Gault equation (Ccr <64, 64 to 75, 75 to 89, and >89 mL/min/1.73 m(2)). OUTCOMES & MEASUREMENTS: Change in carotid IMT during 2 years. Composite clinical study end point is the occurrence of major adverse cardiovascular events, a composite of myocardial infarction, stroke, and vascular death after 2 years. RESULTS: Baseline mean carotid IMT was 0.79 +/- 0.19 (SD) mm. Mean change in carotid IMT was 0.02 +/- 0.11 mm/y. Lower Ccr quartile at baseline was associated with a greater change in adjusted mean values: 0.024 (95% confidence interval [CI], 0.020 to 0.027); 0.019 (95% CI, 0.015 to 0.023); 0.012 (95% CI, 0.009 to 0.016); and 0.0077 (95% CI, 0.005 to 0.011), respectively (P < 0.01). After evaluation of change in carotid IMT, 36 patients (1.1%) experienced a fatal and nonfatal vascular event. Subjects with baseline Ccr less than the median (75 mL/min/1.73 m(2)) and change in carotid IMT greater than the median (0.008 mm/y) had the worst prognosis (log-rank test, P = 0.04). By means of multivariable analysis with the Cox proportional hazard model, lower baseline Ccr (hazard ratio, 1.04; 95% CI, 1.02 to 1.23; P = 0.03 per 1-mL/min/1.73 m(2) decrease) and faster change in carotid IMT (hazard ratio, 1.15; 95% CI, 1.11 to 1.93; P = 0.01 per 0.1-mm increase) were associated with fatal and nonfatal vascular events. LIMITATIONS: Microalbuminuria, associated with carotid atherosclerosis, was not available. CONCLUSION: Decreased kidney function is associated strongly with faster change in carotid IMT. In addition, decreased kidney function and faster change in carotid IMT are associated with cardiovascular events. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/18371534/Kidney_function_and_progression_of_carotid_intima_media_thickness_in_a_community_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(07)01612-5 DB - PRIME DP - Unbound Medicine ER -