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Association of chronic kidney disease with the spectrum of ankle brachial index the CHS (Cardiovascular Health Study).

Abstract：

OBJECTIVES:This study sought to determine the association of chronic kidney disease (CKD) with high ankle brachial index (ABI) measurement and to compare its strength with that of CKD with a low ABI. BACKGROUND:CKD is an important risk factor for cardiovascular disease (CVD) events. A high ABI, a marker of lower extremity arterial stiffness, is associated with CVD events and mortality. The association between CKD and high ABI is unknown. METHODS:The CHS (Cardiovascular Health Study) enrolled community-living people >65 years of age and measured kidney function and ABI. Glomerular filtration rate (GFR) was estimated using equations that incorporated either cystatin C or creatinine, and CKD was defined by estimated GFR <60 ml/min/1.73 m(2). The ABI was categorized as low (<0.90), low-normal (0.90 to 1.09), normal (1.10 to 1.40), and high (>1.40 or incompressible). Multinomial logistic regression was used to evaluate the associations of CKD with ABI categories. RESULTS:Among 4,513 participants, 23% had CKD, 13% had a low ABI, and 3% had a high ABI. In models adjusted for age, sex, race, hypertension, diabetes, smoking, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and C-reactive protein, cystatin C-based CKD was associated with both low ABI (relative risk [RR]: 2.0; 95% confidence interval [CI]: 1.6 to 2.5; p <0.001) and high ABI (RR: 1.6; 95% CI: 1.0 to 2.3; p = 0.03). Results were similar when CKD was defined by creatinine. CONCLUSIONS:CKD is associated with both the high and the low extremes of ABI in community-living older people. Future studies should evaluate whether arterial stiffness is an important mechanism leading to CVD in people with CKD.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Ix JH,Katz R,De Boer IH,Kestenbaum BR,Allison MA,Siscovick DS,Newman AB,Sarnak MJ,Shlipak MG,Criqui MH

doi

10.1016/j.jacc.2009.06.017

subject

Has Abstract

pub_date

2009-09-22 00:00:00

pages

1176-84

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(09)02198-6

journal_volume

pub_type

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Association of chronic kidney disease with the spectrum of ankle brachial index the CHS (Cardiovascular Health Study).