Subclinical carotid atherosclerosis and triglycerides predict the incidence of chronic kidney disease in the Japanese general population: Results from the Kyushu and Okinawa Population Study (KOPS)

Objective: To examine whether or not subclinical atherosclerosis independently predicts the incidence of chronic kidney disease (CKD) in the Japanese general population. Methods: This study is part of the Kyushu and Okinawa Population Study (KOPS), a survey of vascular events associated with lifestyle-related diseases. Participants who attended both baseline (2004-2007) and follow-up (2009-2012) examinations were eligible. The common carotid intima-media thickness (IMT) was assessed for each participant at baseline. The end point was the incidence of CKD, defined as an estimated glomerular filtration rate (eGFR)<60mL/min/1.73m² during the follow-up of participants without CKD at baseline. Results: During the five-year follow-up, 224 of the 1824 participants (12.3%) who developed CKD had higher carotid IMT (0.74±0.22 vs. 0.65±0.14mm, P<0.001), higher triglycerides (1.6±0.8 vs. 1.3±0.7mmol/L, P<0.001), and lower high density lipoprotein cholesterol (1.5±0.4 vs. 1.6±0.4mmol/L, P<0.001) at baseline than those who did not. In logistic regression analysis adjusted for significant covariates, eGFR (Odds ratio [OR] 0.83, 95% confidence interval (CI) 0.80-0.85, P<0.001), carotid IMT (0.10mm increase: OR 1.17, 95% CI 1.04-1.33, P=0.010), and triglycerides (OR 1.35, 95% CI 1.06-1.73, P=0.015) at baseline were independent predictors for the development of CKD. Conclusions: Higher carotid IMT and hypertriglyceridemia were independently associated with the development of CKD in the population studied.