TY - JOUR
T1 - Association of Kidney Function With Coronary Atherosclerosis and Calcification in Autopsy Samples From Japanese Elders
T2 - The Hisayama Study
AU - Nakano, Toshiaki
AU - Ninomiya, Toshiharu
AU - Sumiyoshi, Shinji
AU - Fujii, Hiroshi
AU - Doi, Yasufumi
AU - Hirakata, Hideki
AU - Tsuruya, Kazuhiko
AU - Iida, Mitsuo
AU - Kiyohara, Yutaka
AU - Sueishi, Katsuo
N1 - Funding Information:
Support: This work was supported in part by a grant-in-aid (Drs Nakano, Kiyohara, and Sueishi) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology; a grant-in-aid for Scientific Research C (Dr Nakano, no. 20590342) and A (Dr Kiyohara, no. 18209024; Dr Sueishi, no. 19209012), a grant from the Special Coordination Fund for Promoting Science, and a grant from the Technology and Innovative Development Project in Life Sciences from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
PY - 2010/1
Y1 - 2010/1
N2 - Background: Chronic kidney disease (CKD) is associated with increased risk of coronary heart disease. However, information regarding the histopathologic characteristics of coronary atherosclerosis in individuals with CKD is scarce. This study investigated the relationship between CKD and severity of coronary atherosclerosis in population-based autopsy samples. Study Design: Cross-sectional study. Setting & Participants: 126 individuals randomly selected from 844 consecutive population-based autopsy samples. Predictor: Estimated glomerular filtration rate (eGFR) calculated using the 6-variable Modification of Diet in Renal Disease (MDRD) Study equation. Outcomes: Severity of atherosclerosis in 3 main coronary arteries, including atherosclerotic lesion types defined using the American Heart Association classification; stenosis rates; and coronary calcified lesions. Measurements: The relationship between CKD and severity of coronary atherosclerosis was evaluated using generalized estimating equation methods. Results: Frequencies of advanced atherosclerotic lesions increased gradually as eGFR decreased (33.6%, 41.7%, 52.3%, and 52.8% for eGFRs ≥60, 45-59, 30-44, and <30 mL/min/1.73 m2, respectively; P for trend = 0.006). This relationship was substantially unchanged even after adjustment for potential confounding factors (ORs, 1.40 [95% CI, 0.76-2.55], 2.02 [95% CI, 0.99-4.15], and 3.02 [95% CI, 1.22-7.49] for eGFRs of 45-59, 30-44, and <30 mL/min/1.73 m2, respectively). Frequencies of calcified lesions of coronary arteries also increased gradually with lower eGFRs (P for trend = 0.02). Hypertension and diabetes were associated with increased risk of advanced coronary atherosclerosis and calcification of coronary arteries in individuals with decreased eGFR. Limitations: Cross-sectional study, absence of data for proteinuria, and extremely high proportion of aged people. Conclusions: The autopsy findings presented here suggest that CKD is associated significantly with severity of coronary atherosclerosis. Patients with CKD should be considered a high-risk population for advanced coronary atherosclerosis.
AB - Background: Chronic kidney disease (CKD) is associated with increased risk of coronary heart disease. However, information regarding the histopathologic characteristics of coronary atherosclerosis in individuals with CKD is scarce. This study investigated the relationship between CKD and severity of coronary atherosclerosis in population-based autopsy samples. Study Design: Cross-sectional study. Setting & Participants: 126 individuals randomly selected from 844 consecutive population-based autopsy samples. Predictor: Estimated glomerular filtration rate (eGFR) calculated using the 6-variable Modification of Diet in Renal Disease (MDRD) Study equation. Outcomes: Severity of atherosclerosis in 3 main coronary arteries, including atherosclerotic lesion types defined using the American Heart Association classification; stenosis rates; and coronary calcified lesions. Measurements: The relationship between CKD and severity of coronary atherosclerosis was evaluated using generalized estimating equation methods. Results: Frequencies of advanced atherosclerotic lesions increased gradually as eGFR decreased (33.6%, 41.7%, 52.3%, and 52.8% for eGFRs ≥60, 45-59, 30-44, and <30 mL/min/1.73 m2, respectively; P for trend = 0.006). This relationship was substantially unchanged even after adjustment for potential confounding factors (ORs, 1.40 [95% CI, 0.76-2.55], 2.02 [95% CI, 0.99-4.15], and 3.02 [95% CI, 1.22-7.49] for eGFRs of 45-59, 30-44, and <30 mL/min/1.73 m2, respectively). Frequencies of calcified lesions of coronary arteries also increased gradually with lower eGFRs (P for trend = 0.02). Hypertension and diabetes were associated with increased risk of advanced coronary atherosclerosis and calcification of coronary arteries in individuals with decreased eGFR. Limitations: Cross-sectional study, absence of data for proteinuria, and extremely high proportion of aged people. Conclusions: The autopsy findings presented here suggest that CKD is associated significantly with severity of coronary atherosclerosis. Patients with CKD should be considered a high-risk population for advanced coronary atherosclerosis.
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U2 - 10.1053/j.ajkd.2009.06.034
DO - 10.1053/j.ajkd.2009.06.034
M3 - Article
C2 - 19765871
AN - SCOPUS:71849113772
SN - 0272-6386
VL - 55
SP - 21
EP - 30
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 1
ER -
