Artikel
Carotid Intima-Media thickness and atherosclerotic plaques are associated with renal function decline – a 14-year longitudinal population-based study
Suche in Medline nach
Autoren
Veröffentlicht: | 15. September 2022 |
---|
Gliederung
Text
Hintergrund: The underlying mechanisms of atherosclerosis are often similar to those causing chronic kidney disease e.g., hypertension or diabetes mellitus.
Fragestellung: We investigated if carotid Intima-Media-Thickness (cIMT) and carotid plaques as indicators for atherosclerosis are associated with renal function decline. Furthermore, we compared two equations for calculating the estimated glomerular filtration rate (eGFR).
Methoden: 14-year-follow-up data of 2.904 subjects from the population-based Study of Health in Pomerania (SHIP) were analysed. Chronic kidney disease (CKD) is defined as eGFR < 60ml/min/1.73m2 and albuminuria as urinary albumin-creatinine-ratio (ACR) > 30mg/g, eGFR was calculated by full age spectrum (FAS) equation and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. cIMT and carotid plaques were measured by standardized B-mode-ultrasound protocol. Mixed models were used to associate carotid parameters with change in renal function longitudinally.
Ergebnisse: The age range was 20–79 years with a median of 54 years at baseline. In the longitudinal analyses subjects with a high cIMT showed a greater decrease in eGFR during the follow-up period than subjects with low cIMT (FAS-eGFR: p< 0.001, CKD-EPI-eGFR: p= 0.006). This effect was more evident for the FAS than for the CKD-EPI equation. In subjects with carotid plaques, the decrease in eGFR calculated via FAS was significantly greater than in subjects without plaques (p< 0.001), but not significant for the eGFR calculated by the CKD-EPI equation. Additionally, plaque occurrence was associated with an increased risk of developing a CKD (CKD-EPI-eGFR: p=0.001; FAS-eGFR: p=0.003) as well as albuminuria. No such association was observed for cIMT.
Diskussion: cIMT is more strongly associated with renal function decline, while carotid plaques also correlate with CKD and albuminuria. The FAS equation, in addition to the well-known CKD-EPI equation, represents a significant and appropriate formula for the analysed age group.
Take Home Message für die Praxis: cIMT and carotid plaques should be considered as combined values in potential screenings for kidney function decline.