Low Kidney Function Linked to ASCVD Risk
Low kidney function was associated with a greater risk for developing atherosclerotic cardiovascular disease (ASCVD) among overweight and obese adults with unmedicated high blood pressure, according to a recent study.
In their study, the researchers analyzed data from the Exercise and Nutritional Interventions for Cardiovascular Health (ENCORE) trial. ENCORE included 139 participants who were sedentary, overweight, or obese with unmediated pre-hypertension or Stage I hypertension and an estimated glomerular filtration rate (eGFR) of 60 mL/min/1.73 m2 or more (65% women, mean age 52 years). Carotid artery intima-media thickness (IMT) was measured to assess subclinical atherosclerosis and brachial artery flow-mediated dilation (FMD) was used to assess vascular endothelial function.
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The risk for first ASCVD event was estimated using Pooled Cohorts Equations and linear regression was used to examine the association between eGFR and ASCVD risk, IMT, and FMD.
Overall, eGFR below 15 mL/min/1.73 m2 was associated with a higher ASCVD risk, higher IMT measurements, and lower FMD measurements. Participants with eGFR between 60 and 89 mL/min/1.73 m2 had a higher mean ASCVD risk, greater mean IMT, and lower FMD compared with those with eGFR of 90 mL/min/1.73 m2 or more.
The association between eGFR and IMT remained significant after the researchers adjusted for cardiovascular disease risk factors. Additionally, the researchers found that the association between eGFR and FMD trended toward significance.
“Among overweight and obese adults with unmedicated high blood pressure and eGFR ≥60 mL/min/1.73 m2, lower eGFR is associated with a greater 10-year risk for first ASCVD event, higher IMT and relatively impaired FMD,” the researchers concluded.
—Melissa Weiss
Reference:
Tyson CC, Smith PJ, Sherwood A, Mabe S, Hinderliter AL, Blumenthal JA. Association between normal or mildly reduced kidney function, cardiovascular risk and biomarkers for atherosclerosis: results from the ENCORE trial. Clin Kidney J. 2017;10;5(1):666–671. https://doi.org/10.1093/ckj/sfx025.