Association between renal damage markers and carotid atherosclerosis in Afro-descendants with hypertension belonging to a minority ethnic group from Brazil

Ren Fail. 2018 Nov;40(1):483-491. doi: 10.1080/0886022X.2018.1496932.

Abstract

Ethnicity appears to play an important role in the prevalence and severity of hypertension, renal disease, and atherosclerosis. A cross-sectional study was conducted, including 206 Afro-descendants with hypertension, living in the remaining quilombo communities. These subjects underwent a carotid intima-media thickness (CIMT) assessment. The presence of renal injury was assessed by: (1) The glomerular filtration rate (GFR) estimated by the formula CKD-EPI using creatinine and cystatin C and (2) Albuminuria (ACR ≥30 mg/g). The Poisson distribution model was set with robust variance to identify factors associated with carotid atherosclerosis. The statistical analysis was performed using the Stata 12.0 software, adopting a significance level of 5%. Most subjects were women (61.65%); the average age was 61.32 (±12.44) years. Subjects (12.62%) were identified with GFR <60 mL/min/1.73 m2 and 22.8% with albuminuria. Patients (59.22%) presented with a high CIMT. In the adjusted regression model, age ≥60 years (PR: 1.232 [CI 95%:1.091-1.390], p value = .001), ACR ≥30 mg/g (PR: 1.176 [CI 95%: 1.007-1.373], p = .040), and GFR/CKD-EPI using cystatin C (PR: 1.250 [CI 95%: 1.004-1.557], p = .045) were independently associated with carotid atherosclerosis. The occurrence of atherosclerotic lesions was high in the studied group. Age, albuminuria, and GFR (estimated by the formula CKD-EPI using cystatin C) influenced the prevalence of carotid atherosclerosis.

Keywords: Afro-descendants; Renal damage markers; carotid atherosclerosis; hypertension; minority ethnic group.

MeSH terms

  • Aged
  • Albuminuria / physiopathology*
  • Biomarkers / analysis*
  • Brazil
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / physiopathology*
  • Carotid Intima-Media Thickness
  • Creatinine / analysis
  • Cross-Sectional Studies
  • Cystatin C / analysis
  • Ethnicity
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / physiopathology*
  • Logistic Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Risk Factors

Substances

  • Biomarkers
  • Cystatin C
  • Creatinine

Grants and funding

We are thankful to the Research Support, Scientific and Technological Development Foundation of the State of Maranhão (FAPEMA) for funding this study and publishing the article [grant APP-UNIVERSAL-00347/12].