Predictors of carotid artery intima-media thickness in chronic kidney disease and kidney transplant patients without overt cardiovascular disease.
OBJECTIVE
Carotid intima-media thickness (IMT) assessed using ultrasonography is a widely used marker of atherosclerosis. In the largest study to date of IMT and chronic kidney disease (CKD), we assessed correlates of IMT in CKD patients with a wide range of renal dysfunction, and also investigated what happens to IMT following renal transplantation.


METHODS
We studied 406 patients with different stages of nondiabetic CKD (50% males, 46 +/- 12 years), and 58 kidney transplant recipients (27 +/- 6 years), testing relationships between IMT, assessed by ultrasonography, and selected biomarkers.


RESULTS
Despite a lack of overt CVD, patients had significantly higher IMT as compared to controls (0.9 [0.7-1.0] vs. 0.6 [0.4-0.7] mm; p > 0.001). Furthermore, in multivariate analysis IMT was independently associated with CKD stage, mean arterial pressure (MAP) and calcium-phosphate product, but not with Framingham risk factors. Following kidney transplantation, IMT decreased rapidly, reaching levels comparable to those in the controls within 90 days. In a time-dependent multivariate analysis, this decrease was predicted by changes in GFR, MAP, and uric acid levels.


CONCLUSIONS
Our data does not exclude IMT as a predictor of mortality in CKD, but suggests that other etiologies than atherosclerosis may be more important in determining IMT levels in the population with CKD.
Yilmaz
Mahmut Ilker
MI
Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey. mahmutiyilmaz@yahoo.com
Qureshi
Abdul Rashid
AR
Carrero
Juan Jesus
JJ
Saglam
Mutlu
M
Suliman
Mohamed E
ME
Caglar
Kayser
K
Eyileten
Tayfun
T
Sonmez
Alper
A
Oguz
Yusuf
Y
Vural
Abdulgaffar
A
Yenicesu
Mujdat
M
Axelsson
Jonas
J
D000328:Adult; D015415:Biomarkers; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000401:mortality* / Q000601:surgery*; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; D014527:Uric Acid