Association between carotid artery intima-media thickness and early-stage CKD in a Chinese population

Luxia Zhang, Feng Zhao, Ying Yang, Litong Qi, Baowei Zhang, Fang Wang, Shuyu Wang, Lisheng Liu, Haiyan Wang
American Journal of Kidney Diseases 2007, 49 (6): 786-92

BACKGROUND: Increased carotid artery intima-media thickness (IMT) predicts future vascular events in the general population. However, the relationship between IMT and chronic kidney disease (CKD) seldom was tested in subjects with early-stage CKD.

STUDY DESIGN: Cross-sectional study.

SETTING & PARTICIPANTS: 1,046 residents in 1 district of Beijing participated in the study.

OUTCOMES & MEASUREMENTS: Carotid artery IMT was measured by means of high-resolution B-mode ultrasonography. Estimated glomerular filtration rate (eGFR) was calculated using the modified Modification of Diet in Renal Disease Study equation based on data for Chinese patients with CKD. Albuminuria was evaluated by means of urinary albumin-creatinine ratio on a morning spot urine sample.

RESULTS: Compared with subjects with eGFR greater than 90 mL/min/1.73 m(2) (>1.50 mL/s/1.73 m(2)), subjects with eGFR of 60 to 89 mL/min/1.73 m(2) (1.00 to 1.49 mL/s/1.73 m(2)) and 30 to 59 mL/min/1.73 m(2) (0.50 to 0.99 mL/s/1.73 m(2)) had higher mean IMT (0.74 +/- 0.27 versus 0.82 +/- 0.30 versus 0.94 +/- 0.38 mm; P < 0.001). IMTs of subjects with albuminuria tended to be higher than the mean value (0.79 +/- 0.29 versus 0.93 +/- 0.38 mm; P < 0.001). eGFR and urinary albumin-creatinine ratio significantly correlated with IMT in univariable analysis, but not after adjusting for traditional cardiovascular disease risk factors.

LIMITATIONS: Selection bias and low prevalence of CKD might affect the strength of the study.

CONCLUSIONS: In this Chinese population older than 40 years, carotid artery IMT was significantly higher in subjects with early-stage CKD. The greater prevalence of cardiovascular disease risk factors in patients with CKD appeared to account for the higher carotid artery IMT.

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