Correlation Between Estimated Glomerular Filtration Rate And Carotid Atherosclerosis In Hypertension With Acute Cerebral Infarction Patients

Objectives:To study the correlation betwwen glomerular filtration rate(GFR) on carotid atherosclerosis in hypertension with acute cerebral infarction patients.Methods:Patients with hypertension in the department from the South China university first affiliated Hospital was examined by Head MRI or CT,and than they were divided into hypertension with acute cerebral infarction group(199) and hypertension group by the results of MRI or CT.Clinical date such as name gender、age、biochemical index and complications were recorded detailedly. Carotid IMT was derived via B-mode ultrasonography. e GFR was calculated by the simplified Modification of Diet in Renal Disease( MDRD) equation. The patients were divided into 2 groups: a normal group, a thick group according to the results of carotid ultrasonography. Patients were classified into 3 stages according to e GFR as follows: normal renal function( n=81, e GFR≤ 90ml/(min·1.73m2)), mild renal dysfunction(n=74, 60≤e GFR<90ml/(min·1.73m2)) and moderate or severe renal dysfunction( n=44, e GFR<60ml/(min·1.73m2));Their carotid IMT and carotid atherosclerotic plaque was compared.Correlation of carotid IMT with low GFR and other vascular risk factor was studied by binary logistic analysis.Results : 1.Hypertension complicating acute cerebral infarction group compared with No cerebral infarction group: plaque detection rate, CIMT values, male, diabetes prevalence difference was statistically significant(P < 0.05), Age, coronary heart disease, total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) in no statistical difference between the two groups(P > 0.05), 2 groups for Logistic stepwise regression analysis showed that male, body mass index, glycosylated hemoglobin,CIMT,plaque detection rate are the independent risk factors for cerebral infarction in hypertension patients;2. The thick group compared with normal group,smoking history, blood uric acid level has increased, e GFR level is reduced, the difference was statistically significant(P < 0.05);The moderate or severe renal dysfunction group compared with the normal renal function group and mild renal dysfunction group have a higher age, incidence of coronary heart disease, smoking, blood uric acid levels, CIMT and carotid artery plaque detection rate, the difference was statistically significant(P< 0.05). The mild renal dysfunction group have a higher blood uric acid levels, CIMT values and carotid artery plaque detection rate than that of normal renal function group, the difference was statistically significant(P < 0.05).But the body mass index, gender ratio, diabetes prevalence and glycosylated hemoglobin levels, TC, TG, HDL-C and LDL-C level is no statistical difference(P>0.05) among the three group;3. Logistic stepwise regression analysis showed that smoking(OR = 4.643),blood uric acid levels(OR = 1.874), e GFR(OR = 0.438) are the dangerous factors of CIMT, after correction of the risk factors e GFR is independently associated with CIMT. Age(OR = 1.850) is the risk factors of carotid artery plaque,GFR is not independently correlated with the occurrence of carotid plaques.Conclusion : In patients with hypertension complicating acute cerebral infarction, glomerular filtration rate is independently associated with the carotid intima-media thickness.