Kidney function and thickness of carotid intima-media complex in patients with treated arterial hypertension.

The aim of the study was to evaluate of the association between renal function and the intima-media thickness of common carotid artery (CCA-IMT) in treated hypertensive patients. Eighty-seven hypertensives (51.7% diabetic), aged > 45 years, were examined. Renal function was evaluated by plasma concentration of creatinine, cystatin C ( in 64 patients) and creatinine clearance, calculated according to the Cockcroft - Gault formula. HbA(1c) measurement and blood pressure monitoring were performed. CCA-IMT was measured at near and far wall of the CCA and of the bulb on both sides and averaged. In 63 hypertensives ( 72.4%) IMT was over 0.9 mm. These subjects were older (71.17 +/- 9.72 vs 57.75 +/- 7.76 years; p < 0.0001), had higher pulse pressure (57.45 +/- 11.73 vs 49.35 +/- 8.35, p=0.004), cystatin C concentration (1.25 +/- 0.34 vs 0.99 +/- 0.17 mg/l; p=0.002), higher HbA1c (7.24 +/- 1.59 vs 6.25 +/- 1.28, p=0.01), and lower creatinine clearance (71.28 +/- 28.32 vs 93.86 +/- 25.04; p < 0.0001) in comparison to patients with IMT < 0.9 mm. Groups did not differ with respect to creatinine concentration. The logistic regression analysis showed that CCA-IMT was independently influenced only by age, and the effect of age was stronger in older patients. After exclusion of age, 0.1 mg/l higher concentrations of cystatin C or 10 ml/min lower estimated creatinine clearance were significantly associated with 56% and 34%, respectively, higher probability of CCA-IMT of more than 0.9 mm. Cystatin C concentration seems to be a useful indicator of renal function impairment associated with carotid intima-media thickening. Similar information is obtained when estimated creatinine clearance is used.