Association Between Carotid Artery Intima-Media Thickness and Early-Stage CKD in a Chinese Population

Zhang, LuXia; Zhao, Feng; Yang, Ying; Qi, LiTong; Zhang, BaoWei; Wang, Fang; Wang, ShuYu; Liu, LiSheng; Wang, HaiYan

doi:10.1053/j.ajkd.2007.03.011

« Previous Next »American Journal of Kidney Diseases
Volume 49, Issue 6 , Pages 786-792, June 2007

Association Between Carotid Artery Intima-Media Thickness and Early-Stage CKD in a Chinese Population

LuXia Zhang, MD
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
- L.Z. and F.Z. contributed equally to this work.
Feng Zhao, MD
- Division of Cardiology, Peking University First Hospital, Beijing, China
- L.Z. and F.Z. contributed equally to this work.
Ying Yang, MD
- Division of Cardiology, Peking University First Hospital, Beijing, China
LiTong Qi, MD
- Division of Cardiology, Peking University First Hospital, Beijing, China
BaoWei Zhang, MD
- Division of Cardiology, Peking University First Hospital, Beijing, China
Fang Wang, MD
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
ShuYu Wang, MD
- Beijing Hypertension League Institute, Beijing, China.
LiSheng Liu, MD
- Beijing Hypertension League Institute, Beijing, China.
HaiYan Wang, MD
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
- Address correspondence to HaiYan Wang, MD, Institute of Nephrology and Division of Nephrology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, PR China.

Received 21 November 2006; accepted 19 March 2007.

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 m² (>1.50 mL/s/1.73 m²), subjects with eGFR of 60 to 89 mL/min/1.73 m² (1.00 to 1.49 mL/s/1.73 m²) and 30 to 59 mL/min/1.73 m² (0.50 to 0.99 mL/s/1.73 m²) 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.

Index Words: Intima-media thickness (IMT), chronic kidney disease (CKD), Chinese