Abstract P219: Kidney Measures and Future Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Abdominal aortic aneurysm (AAA) is considered a subtype of atherosclerotic disease, but its risk factor profile is somewhat different than other atherosclerotic disease subtypes. For example, prior studies have demonstrated a null or even inverse association between diabetes and AAA. Chronic kidney disease (CKD) is a known risk factor for cardiovascular outcomes, but its association with AAA has not been explicitly investigated. Methods: We studied 10,722 participants (aged 53-75 years) without clinical history of AAA who attended the ARIC Study fourth visit (1996-98). Cox regression models were used to quantify the association of two key CKD measures—estimated glomerular filtration rate [eGFR] based on serum creatinine and cystatin C and urine albumin-to-creatinine ratio [ACR]—with incidence of AAA-related hospitalizations or deaths (ICD-9 codes: 38.44, 39.71, 441.3, 441.4, or 441.02). Results: During a median follow-up of 14 years, there were 350 cases of AAA (incidence rate 2.5 per 1000 person-years). Both low eGFR and high ACR were associated with increased risk of clinical AAA independently of each other and potential confounders, with a slightly sharper risk gradient for ACR compared to eGFR (Table). We also confirmed an inverse association between diabetes and AAA in our study, although ACR was a significant positive risk factor for AAA risk in both those with and without diabetes. By contrast, low eGFR was associated with AAA risk only in those without diabetes. Conclusion: Both eGFR and ACR were independently associated with increased risk of clinical AAA in the community, suggesting potential usefulness of CKD to identify persons at high risk of AAA beyond traditional atherosclerotic risk factors.