Carotid artery wall shear stress is independently correlated with renal function in the elderly

Abstract

Hemodynamic has increasingly been regarded as an important factor of renal function. However, the relationship between carotid artery wall shear stress (WSS) and renal function is not clarified. To investigate the relationship between carotid WSS and renal function, we recruited 761 older subjects aged 60 years and over from community-dwelling in the Shandong area, China. Carotid WSS, endothelial function, and estimated glomerular filtration rate (eGFR) were assessed in all subjects. Subjects were grouped by the interquartile of the carotid artery mean WSS. We found that the eGFRs derived from serum creatinine and/or cystatin C using three CKD-EPI equations were significantly higher and albumin/creatinine ratio was lower in the higher interquartile groups than in the lower interquartile groups (P <0.05). The mean WSS was independently correlated with eGFRs even after adjustment for confounders. Similar findings were found between carotid artery peak WSS and eGFRs and albumin/creatinine ratio. In addition, we found that endothelial function was strongly related to carotid WSS and renal function after adjustment for confounders. In conclusion, there is an independent correlation of carotid WSS with renal function in the elderly. The local rheologic forces may play an important role in renal function changing. The correlation may be mediated by regulation of endothelial function.

Longitudinal association of carotid endothelial shear stress with renal function decline in aging adults with normal renal function: A population-based cohort study

“…Although there were no significant differences in the incidences of RFI in participants without dyslipidemia and diabetes between the Q 1+2+3 and Q 4 groups, the risks of RFI and albuminuria were higher in the Q 1+2+3 group than the Q 4 group as classified by MWSS and PWSS in participants with/without hypertension, with dyslipidemia, and with diabetes. Moreover, consistent with our previous study 9 , eGFR was significantly lower and ACR was higher in the Q 1+2+3 groups than in the Q 4 groups as classified by MWSS and PWSS, respectively. The results indicated that carotid WSS might be important for the development and progression of RFI and albuminuria in older populations.…”

“…In the CCA, WSS was markedly lower in the prior-to-hemodialysis patients with end-stage renal failure than in the presumed healthy age- and sex-matched control subjects 21 . Our previous study showed that lower carotid artery WSS was closely correlated with lower eGFR and higher ACR 9 . The above-mentioned studies suggested that there is a close relationship between local WSS and chronic kidney diseases.…”

“…A previous study indicated that there was a close relationship between carotid WSS and renal function in aging adults 9 . Higher carotid WSS is related to higher eGFR and lower ACR.…”

“…Chronic RFI is thought to share risk factors for atherosclerosis and endothelial dysfunction 4,8,9 . Among these risk factors, an important hemodynamic force called wall shear stress (WSS) plays a crucial role as a fluid mechanical mediator in endothelial cellular activities and vascular remodeling 10 .…”

“…Baroreceptors, which are stretch-sensitive fibers located primarily in each of the carotid sinuses near the area where the common carotid artery (CCA) bifurcates, provide a common pathway through which precisely regulated systemic blood flows, and there is hemodynamic change 15,16 . The CCA is a well-established “observation window” for monitoring and measurement of systemic hemodynamic conditions in humans, thereby allowing precise regulation of blood flow 17 , and the carotid WSS may represent the overall hemodynamic condition of renal vessels 9,18,19 . Furthermore, chronic RFI is regarded as a part of a subclinical and generalized atherosclerotic-mediated vascular dysfunction 8,9 .…”