Yuanjie Pang1, Yingying Sang1, Shoshana H Ballew1, Morgan E Grams2, Gerardo Heiss3, Josef Coresh1, Kunihiro Matsushita4. 1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; and. 3. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; kmatsus5@jhmi.edu.
Abstract
BACKGROUND AND OBJECTIVES: Carotid intima-media thickness has been reported to predict kidney function decline. However, whether carotid intima-media thickness is associated with a hard kidney end point, ESRD, has not been investigated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 13,197 Atherosclerosis Risk in Communities participants at visit 1 (1987-1989) without history of cardiovascular disease, including coronary heart disease, stroke, and heart failure, at baseline and assessed whether carotid intima-media thickness measured by B-mode ultrasound is associated with ESRD risk using Cox proportional hazards models. Regarding carotid intima-media thickness parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation, and internal carotid arteries) measurements. RESULTS: Mean age was 54.0 (SD=5.7) years old, and there were 3373 (25.6%) blacks and 7370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid intima-media thickness was significantly associated with ESRD risk (hazard ratio [HR] between quartiles 4 and 1, 1.46; 95% confidence interval [95% CI], 1.02 to 2.08 for overall mean intima-media thickness and HR between quartiles 4 and 1, 1.75; 95% CI, 1.24 to 2.48 for overall maximum intima-media thickness). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific intima-media thicknesses, the associations with ESRD were most robust for bifurcation carotid (e.g., adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 1.49; 95% CI, 1.04 to 2.13 for bifurcation; adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 1.36; 95% CI, 0.94 to 1.97 for common; and adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 0.93; 95% CI, 0.67 to 1.29 for internal). CONCLUSIONS: Carotid intima-media thickness was independently associated with incident ESRD in the general population, suggesting the shared etiology of atherosclerosis and ESRD.
BACKGROUND AND OBJECTIVES: Carotid intima-media thickness has been reported to predict kidney function decline. However, whether carotid intima-media thickness is associated with a hard kidney end point, ESRD, has not been investigated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 13,197 Atherosclerosis Risk in Communities participants at visit 1 (1987-1989) without history of cardiovascular disease, including coronary heart disease, stroke, and heart failure, at baseline and assessed whether carotid intima-media thickness measured by B-mode ultrasound is associated with ESRD risk using Cox proportional hazards models. Regarding carotid intima-media thickness parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation, and internal carotid arteries) measurements. RESULTS: Mean age was 54.0 (SD=5.7) years old, and there were 3373 (25.6%) blacks and 7370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid intima-media thickness was significantly associated with ESRD risk (hazard ratio [HR] between quartiles 4 and 1, 1.46; 95% confidence interval [95% CI], 1.02 to 2.08 for overall mean intima-media thickness and HR between quartiles 4 and 1, 1.75; 95% CI, 1.24 to 2.48 for overall maximum intima-media thickness). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific intima-media thicknesses, the associations with ESRD were most robust for bifurcation carotid (e.g., adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 1.49; 95% CI, 1.04 to 2.13 for bifurcation; adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 1.36; 95% CI, 0.94 to 1.97 for common; and adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 0.93; 95% CI, 0.67 to 1.29 for internal). CONCLUSIONS: Carotid intima-media thickness was independently associated with incident ESRD in the general population, suggesting the shared etiology of atherosclerosis and ESRD.
Authors: Daniel E Forman; Javed Butler; Yongfei Wang; William T Abraham; Christopher M O'Connor; Stephen S Gottlieb; Evan Loh; Barry M Massie; Michael W Rich; Lynne Warner Stevenson; James B Young; Harlan M Krumholz Journal: J Am Coll Cardiol Date: 2004-01-07 Impact factor: 24.094
Authors: Essam F Elsayed; Hocine Tighiouart; John Griffith; Tobias Kurth; Andrew S Levey; Deeb Salem; Mark J Sarnak; Daniel E Weiner Journal: Arch Intern Med Date: 2007-06-11
Authors: Victoria Cachofeiro; Marian Goicochea; Soledad García de Vinuesa; Pilar Oubiña; Vicente Lahera; José Luño Journal: Kidney Int Suppl Date: 2008-12 Impact factor: 10.545
Authors: Richard Haynes; David Lewis; Jonathan Emberson; Christina Reith; Lawrence Agodoa; Alan Cass; Jonathan C Craig; Dick de Zeeuw; Bo Feldt-Rasmussen; Bengt Fellström; Adeera Levin; David C Wheeler; Rob Walker; William G Herrington; Colin Baigent; Martin J Landray Journal: J Am Soc Nephrol Date: 2014-05-01 Impact factor: 10.121
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: Caitlin W Hicks; Natalie R Daya; James H Black; Kunihiro Matsushita; Elizabeth Selvin Journal: Atherosclerosis Date: 2019-11-01 Impact factor: 5.162