Subclinical Atherosclerotic Changes Related to Chronic Kidney Disease in Asymptomatic Black and White Young Adults: The Bogalusa Heart Study

Abstract

Chronic kidney disease (CKD) remains asymptomatic until its late stage, and also significantly increases the risk of cardiovascular (CV) disease morbidity and mortality. However, information in scant on the prevalence of CKD, and its association with subclinical atherosclerosis as depicted by carotid intima media thickness (IMT) in younger adults. This cross-sectional study included 1193 participants (43% males, 30% blacks) aged 23 to 43 years, residing in the semi-rural biracial (black-white) community of Bogalusa, Louisiana. The measured variables include estimated glomerular filtration rate (eGFR) to determine functional renal changes and urine album creatinine ratio to diagnose albuminuria, along with CV risk factor variables, and both segmental and composite carotid IMT. Ninety-nine (8.5%) subjects had CKD, with blacks showing higher prevalence than whites (p= .01). Subjects with albuminuria had significantly greater internal carotid IMT (p = .03), common carotid IMT (p = .005), and composite carotid IMT (p = .04) than those without. In the multivariate logistic regression model, albuminuria was associated with black race (odds ratio [OR], 1.92; p = .005), female gender (OR, 2.24; p = .002), diabetes (OR, 6.26; p < .001), hypertension (OR, 2.36; p < .001), obesity (OR, 1.73; p = 0.02), and composite carotid IMT (OR, 1.83; p = .02), after adjusting for age. However, reduction in eGFR did not show significant independent association with carotid IMT. Among asymptomatic young adults, subclinical atherosclerosis and structural renal damage depicted by albuminuria coexist, which has implications for early prevention and control.