Association of aortic atherosclerosis and renal dysfunction

被引:13
作者
Desai, Milind Y. [1 ]
Kwon, Deborah H. [1 ]
Nair, Deepu [1 ]
Mankad, Sunil V. [2 ]
Popovic, Zoran [1 ]
DeCastro, Stefano [3 ]
Nasser, Joachim [3 ]
Patel, Ayan [3 ]
Kuvin, Jeffrey [3 ]
Pandian, Natesa G. [3 ]
机构
[1] Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH 44195 USA
[2] Mayo Clin, Dept Internal Med, Div Cardiol, Rochester, MI USA
[3] Tufts Univ New England Med Ctr, Boston, MA 02111 USA
关键词
aortic atherosclerosis; renal dysfunction; transesophageal echocardiography;
D O I
10.1016/j.echo.2007.10.028
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Both aortic atherosclerosis (AA) and renal dysfunction are associated with increased morbidity and mortality. We sought to assess the association between AA and renal dysfunction. Methods: The study consisted of 200 consecutive patients (62% were male, mean age 69 +/- 11 years) who underwent transesophageal echocardiography. Demographic and clinical data were recorded. On transesophageal echocardiography, descending and aortic arch atherosclerosis were recorded (in millimeters) using off-line planimetry. The patients were graded with normal AA (group 1, n = 83), mild AA (<= 4 mm in thickness, group 2, n = 53), or severe AA (<= 4 mm in thickness or complex, group 3, n = 64). Glomerular filtration rate (GFR) (expressed as milliliters/minute/1.73 meters squared) was calculated as 186 x (serum creatinine(-1.154)) x (age(-0.203)) x 1.212 (if black) x 0.742 (if female). Results: The mean GFR decreased significantly with increasing severity of AA (89 +/- 20 for group 1, 72 +/- 20 for group 2, and 49 +/- 23 for group 3, P < .001). Seventy-three percent of patients with severe atherosclerosis compared with 16% patients with no or mild AA had moderate-severe renal dysfunction (GFR < 60; P < .001). On multiple logistic regression, only the size of the AA and the presence of diabetes mellitus were associated with severe (GFR < 30) renal dysfunction (P < .001, odds ratio 65). On receiver operating curve analysis, the area under the curve for AA predicting severe renal dysfunction was 0.90 (P < .0001). Conclusion: There exists a strong association between AA and renal dysfunction.
引用
收藏
页码:751 / 755
页数:5
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