Subclinical Renal Artery Atherosclerosis, Kidney Function and Hypertension

亚临床肾动脉粥样硬化、肾功能和高血压

• 批准号: 8142002
• 负责人: Matthew A Allison
• 金额: $ 44.03万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8142002
• 关键词: Abdomen; Affect; Albumins; Albuminuria; Aldosterone; Angiotensins; Arterial Fatty Streak; Arteries; Arteriosclerosis; Atherosclerosis; Biological Assay; Blood Pressure; Blood Vessels; Blood specimen; Calcified; Calcium; Cardiovascular Diseases; Chronic; Chronic Kidney Failure; Chymosin; Contralateral; Coronary; Coronary artery; Creatinine; Data; Deposition; Development; Diagnosis; Diastolic blood pressure; Disease; Epidemiology; Ethnic Origin; Ethnic group; Event; Functional disorder; Glomerular Filtration Rate; Hypertension; Image; Individual; Inflammatory; Kidney; Kidney Diseases; Link; Measures; Mediating; Microalbuminuria; Minority Groups; Prevention; Process; Pulse Pressure; Reading; Relative (related person); Renal Hypertension; Renal function; Renin; Risk Factors; Scanning; Serum; Severities; System; Testing; Thoracic aorta; Time; Urine; Woman; Work; X-Ray Computed Tomography; abdominal aorta; arteriole; base; calcification; cardiovascular disorder risk; cardiovascular risk factor; cohort; density; ethnic minority population; follow-up; macroalbuminuria; men; novel; population based; post gamma-globulins; pressure; prospective; renal artery; renal ischemia; vascular bed

DESCRIPTION (provided by applicant): Hypertension (HTN) and chronic kidney disease (CKD) are two highly prevalent and strong risk factors for cardiovascular disease (CVD) that are linked via common risk factors and pathophysiology. Specifically, arteriosclerosis of the preglomerular arterioles leads to relative renal ischemia and subsequent activation of the rennin-angiotensin system ultimately leading to increases in blood pressure. In this proposal, we hypothesize that local (i.e. renal artery) subclinical atherosclerosis is significantly and independently associated with kidney function, blood pressure, hypertension and incident CVD events. Using the Aortic Calcium subsample of 1970 subjects from the Multi-Ethnic Study of Atherosclerosis (MESA), the specific aims for this study are to determine if: 1) Renal artery calcium (RAC) is associated with kidney function, as measured by a) glomerular filtration rate, b) cystatin-C and 3) urine albumin; 2) Both baseline and prospective changes in RAC are significantly associated with changes in kidney function and incident CKD over approximately 3 years of follow-up; 3) RAC is associated with four blood pressure (BP) measures: a) systolic BP, 2) diastolic BP 3) pulse pressure and 4) mean arterial pressure, as well as the diagnosis of hypertension; 4) RAC is significantly associated with both incident hypertension and cardiovascular disease events. If so, we will determine if this association is mediated by differences in kidney function. We will explore these aims by interrogating images from computed tomography (CT) scans of the abdomen. The abdominal CT images will be scored for RAC, kidney volume and kidney density at the MESA CT reading center at UCLA. Blood samples will be assayed for cystatin-C, renin and aldosterone. The cystatin-C results will be used as a measure of kidney function and compared with existing data on serum creatinine and urine albumin. Renin and aldosterone will be used to determine if the presence of RAC is associated with differences in the rennin-angiotensin-aldosterone system. Approximately 700 of the subjects will have had follow-up scans completed by July 2007 allowing for testing of hypotheses involving prospective changes in RAC and kidney function. Finally, the overrepresentation of ethnic minority groups in MESA will allow for testing of interactions with ethnicity. We are unaware of any other population-based study adequate to study the stated aims.

描述（由申请人提供）： 高血压（HTN）和慢性肾脏疾病（CKD）是两个高度普遍且强烈的心血管疾病危险因素（CVD），它们通过常见的危险因素和病理生理学联系在一起。具体而言，前粒细胞动脉的动脉硬化会导致相对的肾脏缺血，并随后激活肾上腺素 - 血管紧张素系统最终导致血压升高。在此提案中，我们假设局部（即肾动脉）亚临床动脉粥样硬化与肾功能，血压，高血压和入射CVD事件显着且独立地相关。使用动脉粥样硬化的多种族研究（MESA）的1970年受试者的主动脉钙子样本，本研究的具体目的是确定：1​​）肾动脉钙（RAC）与肾功能有关，与肾功能相关，如a）通过a）肾小球过滤率测量的， 2）在大约3年的随访中，RAC的基线和前瞻性变化与肾功能的变化和事件CKD显着相关； 3）RAC与四个血压（BP）措施有关：a）收缩BP，2）舒张压BP 3）脉搏压力和4）平均动脉压，以及高血压的诊断； 4）RAC与入射高血压和心血管疾病事件均显着相关。如果是这样，我们将确定该关联是否是由肾功能差异介导的。我们将通过询问腹部计算机断层扫描（CT）扫描的图像来探索这些目标。腹部CT图像将在UCLA的Mesa CT阅读中心为RAC，肾脏体积和肾脏密度评分。血液样本将用于胱抑素-C，肾素和醛固酮。胱抑素-C结果将用作肾脏功能的度量，并将其与血清肌酐和尿白蛋白的现有数据进行比较。肾素和醛固酮将用于确定RAC的存在是否与肾上腺素 - 血管紧张素 - 醛固酮系统的差异有关。大约700名受试者将在2007年7月之前完成后续扫描，以测试涉及RAC和肾功能的前瞻性变化的假设。最后，台面少数族裔群体的过分占代表性将允许测试与种族的互动。我们不知道任何其他基于人群的研究足以研究既定目标。

项目成果

Superior mesenteric artery calcification is associated with cardiovascular risk factors, systemic calcified atherosclerosis, and increased mortality.

• DOI: 10.1016/j.jvs.2017.08.081
• 发表时间: 2018-05
• 期刊: Journal of vascular surgery
• 影响因子: 4.3
• 作者: Lin TC;Wright CM;Criqui MH;Allison MA
• 通讯作者: Allison MA