Characteristics and predictors of low-grade renal artery stenosis in female patients with CKD

Figures & data

Table 1. Baseline characteristics of subjects included according to with or without RAS.

Variables	All subjects (n = 105)	RAS(-) (n = 55)	RAS(+) (n = 50)	P -value
Age(years)	63.71 ± 12.99	59.89 ± 12.40	68.00 ± 12.40	0.001***
BMI(kg/m^2)	23.37(21.15,25.75)	23.83(21.72,27.27)	23.05(21.00,25.00)	0.115
hypertension(%)	87 (82.9%)	43(78.2%)	44(88.0%)	0.182
Diabetes mellitus(%)	43 (41.0%)	16(29.1%)	27(54.0%)	0.010**
Lymphocyte (%)	26.32 ± 9.79	28.82 ± 9.67	23.66 ± 9.30	0.008**
Monocyte(%) Neutrophil(%)	5.70(4.80,7.10) 64.31 ± 10.21	5.65(4.83,6.78) 62.62 ± 10.93	5.80(4.80,7.50) 66.11 ± 9.15	0.417 0.086
Fibrinogen(g/l)	3.30(2.61,4.08)	2.97(2.39,3.69)	3.66(2.95,4.43)	0.002**
ALB(g/l)	38.64 ± 4.93	39.96 ± 4.83	37.2 ± 4.67	0.004**
TC(mmol/l)	4.68 ± 1.04	4.59 ± 1.08	4.78 ± 0.99	0.337
TG(mmol/l) LDL(mmol/l)	1.60(1.25,2.37) 2.62(2.17,3.31)	1.53(1.08,2.31) 2.51(2.06,3.30)	1.73(1.35,2.71) 2.66(2.28,3.60)	0.089 0.283
BUN(mmol/l)	8.10(6.00,13.60)	7.2(5.30,11.10)	9.85(7.15,16.88)	0.002**
Scr(umol/l)	126.40(85.40,221.20)	96.90(74.60,173.00)	170.25(99.28,277.53)	0.002**
eGFR(ml/min/1.73 m^2)	42.53 ± 28.58	51.70 ± 29.43	32.45 ± 24.11	<0.001***
SUA(umol/l)	378.84 ± 108.80	363.78 ± 108.63	395.41 ± 107.64	0.138
Sca(mmol/l)	2.24(2.15,2.34)	2.24(2.15,2.37)	2.24(2.15,2.33)	0.881
SK(mmol/l)	3.97 ± 0.48	3.92 ± 0.46	4.02 ± 0.49	0.289
SP(mmol/l)	1.30(1.12,1.46)	1.22(1.10,1.39)	1.44 ± 0.451.32(1.18,1.56)	0.037*
SNa(mmol/l)	141.61 ± 2.26	141.76 ± 2.10	141.44 ± 2.43	0.469
Scl(mmol/l)	104.94 ± 3.61	104.87 ± 3.47	105.01 ± 3.78	0.838
PTH(pg/ml)	47.90(33.95,79.50)	43.90(32.60,73.1)	50.60(34.3,96.78)	0.543
25-OHD3(ng/ml)	12.70(8.75,19.00)	13.20(9.05,19.05)	11.80(8.25,19.05)	0.512
UBCR(ug/g)	3580.04(1873.91,7612.80)	2951.00(1804.52,5022.69)	5757.05(2400.08,11535.05)	0.010**
FENa(%)	1.07(0.72,2.19)	0.86(0.60,1.38)	1.74(0.96,2.95)	<0.001***
HbA1C(%) NLR	6.00(5.50,6.50) 2.47(1.75,3.80)	6.00(5.50,6.40) 2.00(1.64,3.25)	5.95(5.50,6.85) 2.85(2.06,4.22)	0.486 0.007**

Notes: Data are presented as mean ± SD, median ± interquartile range and percentage, where appropriate. *Denotes statistically differences between the two groups. *<0.05; **<0.01; ***<0.001.

Abbreviations: RAS: renal artery stenosis; BMI, body mass index; ALB: albumin; TC: cholesterol; TG: triglycerides; BUN: ureanitrogen; Scr: serum creatinine; GFR: glomerular filtration rate; SUA: serum uric acid; SK: serum potassium; SP: serum phosphorus; SNa: serum sodium; Scl: serum chlorine; PTH: parathyroid hormone; UBCR: urinary β2 microglobulin-creatinine ratio; FENa: urinary sodium excretion fraction; HbA1C: Glycosylated Hemoglobin, Type A1C.

Table 2. The association of ALB, lymphocyte count, fibrinogen, SP, BUN and NLR with low-grade RAS in female patients with CKD.

	Model I	P value	ModelII	P value
ALB	0.881(0.804–0.964)	0.006**	0.880(0.792–0.979)	0.018*
Lymphocyte count	0.943(0.902–0.986)	0.010*	0.928(0.879–0.979)	0.006**
fibrinogen	1.161(0.874–1.542)	0.304	0.981(0.778–1.237)	0.873
SP	3.820(1.153–12.654)	0.028*	7.518(1.359–41.597)	0.021*
BUN	1.090(1.024–1.161)	0.007**	1.111(1.024–1.205)	0.012*
NLR	1.171(0.936–1.465)	0.167	1.280(0.968–1.693)	0.084

Note: *<0.05, **<0.01, ***<0.001.

Abbreviations: ALB: serum albumin, NLR: neutrophil-to-lymphocyte ratio.

Figure 1. The proportion of low-grade RAS in ALB, lymphocyte count, fibrinogen, SP,BUN and NLR tertiles.(A) The proportion of low-grade RAS in ALB tertiles. (B) The proportion of low-grade RAS in lymphocyte count tertiles. (C) The proportion of low-grade RAS in fibrinogen tertiles. (D) The proportion of low-grade RAS in SP tertiles. (E) The proportion of low-grade RAS in BUN tertiles. (F) The proportion of low-grade RAS in NLR tertiles.

Notes: *:<0.05; **:<0.01; ***:<0.001

Figure 2. Logistic regression estimation of the effect of ALB, lymphocyte count, fibrinogen, SP, BUN and NLR on low-grade renal artery stenosis. (A) Multinomial-adjusted ORs for low-grade RAS according to ALB tertiles; the first tertile was used as a reference. (B) Multinomial-adjusted ORs for low-grade RAS according to lymphocyte tertiles; the first tertile was used as a reference. (C) Multinomial-adjusted ORs for low-grade RAS according to fibrinogen tertiles; the first tertile was used as a reference. (D) Multinomial-adjusted ORs for low-grade RAS according to SP tertiles; the first tertile was used as a reference. (E) Multinomial-adjusted ORs for low-grade RAS according to BUN tertiles; the first tertile was used as a reference.(F) Multinomial-adjusted ORs for low-grade RAS according to NLR tertiles; the first tertile was used as a reference.

Notes: adjusted confounders include age, hypertension, diabetes mellitus, TC, TG, FBS, LDL and HDL.

Abbreviations: ORs: odds ratios, ALB: serum albumin; SP: serum phosphorus; BUN: serum urea nitrogen. NLR: neutrophil-to-lymphocyte ratio. Low-grade RAS: low-grade renal artery stenosis.

Figure 3. ROC curve of the diagnostic accuracy of lymphocyte count, NLR, ALB, eGFR, UBCR, and FeNa in low-grade renal artery stenosis.

Abbreviations: NLR: neutrophil-to-lymphocyte ratio, FeNa: urinary sodium excretion fraction, eGFR: estimated glomerular filtration ratio, UBCR: urinary β2 microglobulin-creatinine ratio, ALB: serum albumin.

Table 3. The outcome of ROC of the following variables predicting low-grade renal artery stenosis.

variable	AUC	Cutoff point	Sensitivity (%)	Specificity (%)
eGFR	0.698	40.74 ml/min/1.73 m^2	65.50	72.00
FeNa(%)	0.714	1.11%	71.10	72.20
UBCR	0.739	4684.26ug/g	71.10	68.10
ALB	0.681	38.75 g/l	65.50	66.00
Lymphocyte count (%)	0.667	25.60%	65.40	61.20
NLR	0.657	2.35	67.30	63.50

Abbreviations: eGFR: estimated glomerular filtration ratio, FeNa: urinary sodium excretion fraction, UBCR: urinary β2 microglobulin-creatinine ratio, ALB: serum albumin, NLR: neutrophil-to-lymphocyte ratio, AUC: the area under the curve.