Relations of Measures of Endothelial Function and Kidney Disease: The Framingham Heart Study

Meredith C. Foster, Michelle J. Keyes, Martin G. Larson, Joseph A. Vita, Gary F. Mitchell, James B. Meigs, Ramachandran S. Vasan, Emelia J. Benjamin, Caroline S. Fox

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Endothelial dysfunction is prevalent in individuals with end-stage renal disease. Whether endothelial dysfunction is present in patients with moderate chronic kidney disease (CKD) is uncertain. Study Design: Cross-sectional study. Settings & Participants: Brachial reactivity measurements were obtained during the seventh examination cycle in 2,818 (diameter measurements) and 2,256 (flow measurements) Framingham Heart Study Offspring cohort participants (53% women; mean age, 61 ± 9 years). Predictor: Estimated glomerular filtration rate less than 60 mL/min/1.73 m2 derived from creatinine- and cystatin C-based estimating equations; microalbuminuria status. Outcome: Brachial reactivity measurements (baseline brachial diameter, flow-mediated dilation, baseline and hyperemic mean flow). Measurements: Linear regression models were used to model brachial measures as a function of CKD and microalbuminuria status. Results: Overall, 7.3% (n = 206) of participants had CKD, and of 2,301 with urinary measurements, 10.0% (n = 230) had microalbuminuria. Brachial reactivity measures did not differ significantly by CKD status in either creatinine- or cystatin C-based equations in either age- and sex- or multivariable-adjusted models. In age- and sex-adjusted models, microalbuminuria was associated with decreased hyperemic mean flow (47.2 ± 1.4 versus 51.4 ± 0.5 mg/g; P = 0.005), but the association was not significant after multivariable adjustment (P = 0.09). Limitations: Predominantly white ambulatory cohort; results may not be generalizable to other ethnic groups or individuals with severe CKD. Conclusions: Endothelial dysfunction was not a major correlate of CKD in our sample.

Original languageEnglish (US)
Pages (from-to)859-867
Number of pages9
JournalAmerican Journal of Kidney Diseases
Issue number5
StatePublished - Nov 2008
Externally publishedYes


  • brachial reactivity
  • Chronic kidney disease
  • cystatin C
  • Framingham Heart Study

ASJC Scopus subject areas

  • Nephrology


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