Association between renal surface nodularity and increased adverse vascular event risk in patients with arterial hypertension

ABSTRACT

Objective

To explore the association of renal surface nodularity (RSN) with the increased adverse vascular event (AVE) risk in patients with arterial hypertension.

Methods

This cross-sectional study included patients with arterial hypertension aged 18–60 years who underwent contrasted computed tomography (CT) of kidney from January 2012 to December 2020. The subjects were classified into AVE or not (non-AVE) matched with age (≤5 years) and sex. Their CT images were analyzed using both qualitative (semiRSN) and quantitative RSN (qRSN) methods, respectively. Their clinical characteristics included age, sex, systolic blood pressure (SBP), diastolic blood pressure, hypertension course, diabetes history, hyperlipidemia, and estimated glomerular filtration rate (eGFR).

Results

Compared with non-AVE group (n = 91), AVE (n = 91) was at lower age, higher SBP, and fewer rate of diabetes and hyperlipidemia history (all P < .01). Rate of positive semiRSN was higher in AVE than non-AVE (49.45% vs 14.29%, P < .001). qRSN was larger in AVE than non-AVE [1.03 (0.85, 1.33) vs 0.86 (0.75,1.03), P < .001]. The increased AVE was associated with semiRSN (odds ratio = 7.04, P < .001) and qRSN (odds ratio = 5.09, P = .003), respectively. For distinguishing AVE from non-AVE, the area under receiver operating characteristic was bigger in the models combining the clinical characteristics with either semiRSN or qRSN than that of semiRSN or qRSN alone (P ≤.01).

Conclusion

Among the patients with arterial hypertension aged 18–60 years, CT imaging-based RSN was associated with increased AVE risk.

KEYWORDS:

• renal surface nodularity
• hypertension
• subclinical renal damage
• adverse vascular event
• tomography

Disclosure statement

No potential conflict of interest was reported by the author(s).

Informed consent statement

Informed consent was waived because of the retrospective setting of this study.

Data availability statement

The study data is not available in a public database. However, data can be requested from the corresponding author.

Additional information

Funding

This study has received funding by National Natural Science Foundation of China (82171901) and Science and Technology Program of Changzhou, Jiangsu, China (CZ20200036).Institutional review board statementThe study was approved by the institutional review board and local ethics committee (The Ethics Committee of the First People’s Hospital of Changzhou).