Carotid intima-media thickness and atherosclerotic plaques are associated with renal function decline: a 14-year longitudinal population-based study.

Abstract

Chronic kidney disease (CKD) leads to increased morbidity and mortality. The underlying causes of CKD are often similar to those of atherosclerosis. We investigated whether carotid atherosclerotic parameters are associated with renal function decline. Within the population-based Study of Health in Pomerania (SHIP), Germany, 2904 subjects were observed over 14years. The carotid intima-media thickness (cIMT) as well as carotid plaques were measured by standardized B-mode ultrasound protocol. CKD is defined as estimated glomerular filtration rate (eGFR) <60mL/min/1.73 m2 and albuminuria as urinary albumin-creatinine ratio (ACR) ≥30mg/g. eGFR was calculated by the full age spectrum (FAS) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Mixed models were applied to associate carotid parameters with change in renal function longitudinally and adjusted for confounding. The age range of the study sample was 25-86years with a median of 54years at baseline. In longitudinal analyses, subjects with high cIMT and the presence of plaques at baseline showed a greater decrease in eGFR (cIMT: FAS-eGFR: P<.001, CKD-EPI-eGFR: P<.001; plaques: FAS-eGFR: P<.001, CKD-EPI-eGFR: n.s.) as well as an increased risk of developing CKD during the follow-up (cIMT: FAS-eGFR: P=.001, CKD-EPI-eGFR: P=.04; plaques: FAS-eGFR: P=.008, CKD-EPI-eGFR: P=.001). There was no association between atherosclerotic parameters and the risk of developing albuminuria. cIMT and carotid plaques are associated with renal function decline as well as CKD in a population-based sample. Furthermore, the FAS equation adapts best to this study population.