eGFR is associated with subclinical atherosclerosis independent of albuminuria: The Dong-gu Study

Received 8 February 2010; received in revised form 10 June 2010; accepted 23 June 2010. published online 27 July 2010.
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Abstract

Objectives

This study evaluated the relationships between estimated glomerular filtration rate (eGFR) and carotid atherosclerosis, peripheral arterial disease (PAD), arterial stiffness, and left ventricular hypertrophy, independent of albuminuria.

Methods

The study population consisted of 6694 people aged 50 years and older who participated in the baseline survey of the Dong-gu Study conducted in Korea between 2007 and 2009. The common carotid artery intima-media thickness (CCA-IMT), carotid plaque, ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and left ventricular mass index (LVMI) of each subjects was assessed.

Results

After adjustment for risk factors and albumin–creatinine ratio (ACR), kidney dysfunction (eGFR=30–44ml/min per 1.73m2) was significantly associated with carotid plaque presence (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.21–2.53) and PAD (OR, 2.64; 95% CI, 1.51–4.62) compared to normal kidney function (eGFR≥60ml/min per 1.73m2). Similarly, mean LVMI and baPWV differed significantly according to eGFR after adjustment for other risk factors and ACR; in contrast, no significant difference was observed for CCA-IMT.

Conclusions

Independent of albuminuria, eGFR is associated with carotid plaque, PAD, baPWV, and LVMI but not with CCA-IMT in Koreans aged 50 years and older.

Keywords: Estimated glomerular filtration rate, Carotid artery intima-media thickness, Peripheral arterial disease, Pulse wave velocity, Left ventricular mass index, Subclinical atherosclerosis

a Department of Overseas Hospital Consulting, Korea Health Industry Development Institute, 57-1, Norayngjin-dong, Dongjak-gu, Seoul 156-800, Republic of Korea

b Department of Preventive Medicine, Seonam University College of Medicine, 720, Kwangchi-dong, Namwon, Jeollabukdo 590-711, Republic of Korea

c Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, Republic of Korea

d Department of Preventive Medicine, Chosun University Medical School, 375, Seosuk-dong, Gwangju 501-759, Republic of Korea

e Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanamdo 519-809, Republic of Korea

f Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak-1-dong, Dong-gu, Gwangju 501-746, Republic of Korea

Corresponding author. Tel.: +82 62 220 4166; fax: +82 62 233 0305.

PII: S0021-9150(10)00496-X

doi:10.1016/j.atherosclerosis.2010.06.039