Increased carotid intima-media thickness (CIMT), as measured by ultrasonography, is associated with an elevated risk of CKD in the elderly, researchers reported in Nephrology Dialysis Transplantation (2008;23:2593-2598).
Michel Chonchol, MD, of the University of Colorado Health Sciences Center in Denver, and his colleagues studied 2,751 individuals in Bavaria, Germany born before 1946 and who had normal baseline renal function. CKD, defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min per 1.73 m2, developed in 548 subjects during follow-up.
Patients with a baseline CIMT of less than 0.66, 0.66-0.77, 0.77-0.88, and greater than 0.88 mm (quartiles 1-4, respectively) experienced an average rate of decline in eGFR of 8, 10, 11, and 15 mL/min per 1.73 m2, respectively, during the two-year follow-up period.
After adjusting for traditional and non-traditional risk factors for CKD, patients in the fourth quartile of baseline CIMT were at significantly higher risk of CKD compared with patients in the first quartile. Each 0.10 mm increment in baseline CIMT increased CKD risk by 17%.
The researchers say their report is the first to show that individuals with subclinical carotid atherosclerosis are high-risk populations for CKD.