Original InvestigationPathogenesis and Treatment of Kidney DiseaseCystatin C and Carotid Intima-Media Thickness in Asymptomatic Adults: The Multi-Ethnic Study of Atherosclerosis (MESA)
Section snippets
Participants
MESA is a community-based prospective cohort study designed to characterize subclinical cardiovascular disease and its progression. Its participants include 6,814 men and women free of clinical cardiovascular disease, aged 45 to 84 years, from 4 different self-reported ethnic groups (white, African American, Hispanic, and Chinese) recruited to meet prespecified race/ethnicity proportions. Participants were enrolled between July 2000 and August 2002 from 6 US communities (Baltimore, MD; Chicago,
Results
For the 6,557 participants, mean age was 62 years, 47% were men, and race/ethnicity distribution was 39% white, 27% African American, 22% Hispanic, and 12% Chinese. Mean cystatin C level was 0.89 ± 0.23 mg/L, and mean eGFR was 79 ± 18 mL/min/1.73 m2. Baseline characteristics of the study sample by quintiles of cystatin C level are listed in Table 1. Compared with participants in the lowest cystatin C quintile (≤0.74 mg/L), those in the highest cystatin C quintile (≥1.03 mg/L) were older, more
Discussion
In individuals without clinical cardiovascular disease, mild kidney impairment measured using cystatin C level was strongly associated with common and internal carotid IMT in unadjusted analyses. However, this relationship was accounted for predominately by age. We found no independent association between either cystatin C level or CKD with common or internal carotid IMT. This observation suggests that accelerated atherosclerosis is unlikely to be the primary mechanism explaining the
Acknowledgements
The authors thank the other investigators, staff, and participants of MESA for valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.
Support: This research was supported by contracts N01-HC-95159 through N01-HC-95167 from the National Heart, Lung, and Blood Institute (NHLBI). Dr Shlipak is supported by R01 DK066488-01 and the American Heart Association Established Investigator Award. Dade Behring Inc donated to MESA
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Cited by (51)
Vascular inflammation and media calcification are already present in early stages of chronic kidney disease
2017, Cardiovascular PathologyChronic kidney failure and carotid atherosclerosis in diabetic patient
2016, Presse MedicaleCorrelation between Carotid Intima-Media Thickness and Early-Stage Chronic Kidney Disease: Results from Asymptomatic Polyvascular Abnormalities in Community Study
2016, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :Recently, it has been recognized that chronic kidney disease (CKD) is not only a strong predictor for cardiovascular disease but also a potential risk factor for increased carotid IMT.4-6 However, the role of kidney dysfunction as an independent risk factor for increased carotid IMT remains controversial, especially in the low-risk general population.7-9 We hypothesized that subjects with kidney dysfunction would have a greater quantity of increased IMT compared with individuals with normal kidney function.
Stroke and cerebrovascular diseases in patients with chronic kidney disease
2014, The Lancet NeurologyCitation Excerpt :Carotid atherosclerosis is both a predictor of future cardiovascular diseases and a direct embolic source to the brain. Findings from cross-sectional studies of the general population have shown an inverse association of intima-media thickness of the carotid artery with renal function.47–49 The association seems to be stronger in Asian than in white populations,50,51 and is also stronger in patient cohorts than in healthy populations.52–56
An improved method to extract and purify cystatin from hen egg white
2014, Journal of Chromatography B: Analytical Technologies in the Biomedical and Life SciencesSubclinical cardiovascular disease is associated with a high glomerular filtration rate in the nondiabetic general population
2014, Kidney InternationalCitation Excerpt :The cross-sectional relationship between GFR and carotid atherosclerosis has been examined previously. Several studies have found no statistically significant association between GFR and IMT,13,14 whereas two studies found an association between low GFR and increased IMT.15,16 The conflicting results may reflect shortcomings of the GFR assessments, as all these studies used GFR estimates rather than measured GFR.
Originally published online as doi:10.1053/j.ajkd.2008.06.025 on September 29, 2008.
Because the Editor-in-Chief recused himself from consideration of this manuscript, the peer-review and decision-making processes were handled entirely by a Co-Editor (Wolfgang C. Winkelmayer, MD, ScD, Harvard Medical School) who served as Acting Editor-in-Chief. Details of the journal's procedures for potential editor conflicts are given in the Editorial Policies section of the AJKD website.