Maximum Carotid Intima-Media Thickness in Association with Renal Outcomes

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 28; no. 5; pp. 491 - 505
• Main Authors: Manabe, Shun, Kataoka, Hiroshi, Mochizuki, Toshio, Iwadoh, Kazuhiro, Ushio, Yusuke, Kawachi, Keiko, Watanabe, Kentaro, Watanabe, Saki, Akihisa, Taro, Makabe, Shiho, Sato, Masayo, Iwasa, Naomi, Yoshida, Rie, Sawara, Yukako, Hanafusa, Norio, Tsuchiya, Ken, Nitta, Kosaku
• Format: Journal Article
• Language: English
• Published: Japan Japan Atherosclerosis Society 01.05.2021
• Subjects: Chronic kidney disease; Elderly; Interactions; Maximum carotid intima-media thickness; Original; Prognosis; Maximum carotid intima-media thickness; Chronic kidney disease; Prognosis; Interactions; Elderly
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.57752

Aim: We aimed to examine the association between the maximum intima-media thickness of the carotid artery (Max IMT) and renal prognosis, considering their potential interaction with age. Methods: Survival analyses were performed in 112 patients with chronic kidney disease (CKD), to assess renal prognosis, with the endpoint defined as a ≥ 30% decline in estimated glomerular filtration rate (eGFR) or end-stage renal disease. Results: During a median follow-up of 12.5 years, 44 participants reached the study endpoint. The major determinant of Max IMT was the maximum IMT of the internal carotid artery (Max ICA-IMT), which was the distribution ratio of 50.0% of Max IMT. Kaplan–Meier analyses showed that Max IMT ≥ 1.5 mm was significantly associated with renal prognosis when age and eGFR were matched. On multivariate Cox regression analysis, Max IMT was significantly associated with the renal outcomes and had a significant interaction with the age categories (≥ 65 years or ＜65 years) (P=0.0153 for interaction). A 1-mm increase in Max IMT was significantly associated with disease progression in the sub-cohort ＜65 years age-category, but not in the ≥ 65 years age-category; similarly the hazard ratio (HR) in the ＜65 years age-category was higher than in the ≥ 65 years age-category (HR: 2.52 vs. 0.95). Comparable results were obtained for Max ICA-IMT, Max bulb-IMT, but not for Max common carotid artery-IMT. Conclusions: A higher Max IMT was a significant renal prognosis factor in patients with CKD aged ＜65 years. Our results may provide new insights into treating CKD.