title: Predictors of carotid artery intima-media thickness in chronic kidney disease and kidney transplant patients without overt cardiovascular disease.
abstract: 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.
authors.affiliation: Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey. mahmutiyilmaz@yahoo.com
authors.forename: Mahmut Ilker
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: Abdul Rashid
authors.initials: AR
authors.lastname: Qureshi
authors.forename: Juan Jesus
authors.initials: JJ
authors.lastname: Carrero
authors.forename: Mutlu
authors.initials: M
authors.lastname: Saglam
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Suliman
authors.forename: Kayser
authors.initials: K
authors.lastname: Caglar
authors.forename: Tayfun
authors.initials: T
authors.lastname: Eyileten
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Oguz
authors.forename: Abdulgaffar
authors.initials: A
authors.lastname: Vural
authors.forename: Mujdat
authors.initials: M
authors.lastname: Yenicesu
authors.forename: Jonas
authors.initials: J
authors.lastname: Axelsson
mesh_terms: 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
chemical_list: D015415:Biomarkers; D014527:Uric Acid