title: Chronic kidney disease is associated with increased carotid artery stiffness without morphological changes in participants of health check-up programs.
abstract: METHODS
  Patients with chronic kidney disease (CKD) show a much higher risk of cardiovascular disease. However, the mechanisms underlying this association and the impact of CKD on behaviors of the vascular walls have not been fully clarified. Using ultrasonography, this study investigated associations of CKD (estimated glomerular filtration rate <60 ml/min/1.73 m(2) and/or presence of proteinuria) with both elasticity (stiffness β index) of the carotid artery and intimal atherosclerotic changes in participants of health check-up programs (n=3406, 63% men; mean age, 58.8 years).
  
  
  RESULTS
  Stiffness β was significantly higher in CKD subjects (7.49 ± 0.14) than in non-CKD subjects (6.87 ± 0.05, P<0.001). This significant difference was maintained in a multiple adjusted model including conventional risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking and obesity (7.20 ± 0.14 vs. 6.91 ± 0.05, P=0.043). No significant differences in intima-media complex thickness or plaque score were seen between CKD and non-CKD subjects.
  
  
  CONCLUSIONS
  In participants of health check-up programs, CKD was associated with increased carotid arterial stiffness without intimal disease, independently of conventional risk factors. These findings indicate that CKD may predispose the carotid arteries to earlier development of arteriosclerosis, characterized by increased arterial stiffness.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 0208505, Japan. makitas@seagreen.ocn.ne.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Makita
authors.forename: Akihiko
authors.initials: A
authors.lastname: Abiko
authors.forename: Yujirou
authors.initials: Y
authors.lastname: Naganuma
authors.forename: Mizuyoshi
authors.initials: M
authors.lastname: Nagai
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015233:Models, Statistical; D011507:Proteinuria / Q000175:diagnosis; D014463:Ultrasonography / Q000379:methods