Abstract P086: Endothelial Dysfunction Markers And Incident Chronic Kidney Disease In The Regards Cohort

Abstract

Background: Much of chronic kidney disease (CKD) is unexplained by traditional risk factors. Endothelial dysfunction is highly prevalent in CKD and may be a potential target for reducing CKD incidence or progression. We sought to determine the association of plasma biomarkers of endothelial dysfunction with incident CKD in a large prospective cohort. Methods: REGARDS is a prospective population-based cohort of 30,239 Black and White US adults aged ≥45. Baseline biomarkers of endothelial dysfunction (plasma factor VIII, E-selectin, intercellular cellular adhesion molecule 1 (ICAM-1), and vascular cellular adhesion molecule 1 (VCAM-1)) were measured in individuals without CKD who attended a second visit a median of 9.4 years after baseline. Incident CKD was defined as eGFR <60 ml/min/1.73m 2 and a decline of 40%. We used sequential logistic regression models adjusted for confounders to assess associations and tested for interactions by each of age, sex, race, and diabetes. Results: After exclusions, we studied 3,300 participants (median age 62, 49% women, 46% Black, 50% hypertensive, 15% diabetic). 228 (6.9%) developed CKD by the second visit. Substantial interactions were observed for several markers, so stratified analyses were presented (Table). In minimally adjusted models, independent positive associations with CKD were seen with higher levels of each marker: factor VIII in White non-diabetics, E-selectin in women <65 years, ICAM-1 in all participants, and VCAM-1 in White men and women (Table). Final adjustment attenuated associations in some groups, but not all. Among the above minimally adjusted results, all associations remained independent after final adjustment except models for VCAM-1; trends for increased CKD with higher VCAM-1 were apparent in White women and Black men, but these were not statistically significant. Conclusion: Several plasma markers of endothelial dysfunction were highly relevant to CKD incidence in important subgroups, which may reveal insights into reducing the burden of CKD.