title: Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries.
abstract: BACKGROUND
  The objective of the study was to determine the relationship between common carotid artery intima-media thickness (CCA-IMT) and histologically assessed calcification of radial artery in relation to clinical features and laboratory markers of bone and mineral metabolism, inflammation, and oxidative stress in patients with stage 5 chronic kidney disease (CKD).
  
  
  METHODS
  The study comprised 59 patients (36 hemodialyzed, 23 predialysis). CCA-IMT was measured by ultrasonography; the biochemical parameters examined were assessed using routine laboratory methods, ELISA micro-plate immunoassays and spectrophotometry. Fragments of radial artery obtained during creation of hemodialysis access were cryosectioned and stained for calcifications using von Kossa method and alizarin red.
  
  
  RESULTS
  Glucose, osteoprotegerin, pentraxin 3 and Framingham risk score significantly correlated with CCA-IMT. In multiple regression analysis, OPG positively predicted CCA-IMT. Radial artery calcifications were found in 34 patients who showed higher CCA-IMT (0.98 ± 0.13 vs 0.86 ± 0.14 mm; P = 0.006). Higher CCA-IMT values were also associated with more advanced calcifications. CCA-IMT and the presence of plaques in common carotid artery were positive predictors of radial artery calcifications, independent of dialysis status, Framingham risk score, CRP and Ca x Pi [OR for calcifications 2.19 (1.08-4.45) per 0.1 mm increase in CCA-IMT]. The presence of radial artery calcifications was a significant predictor of mortality, independent of dialysis status and Framingham risk score [HR 3.16 (1.03-9.64)].
  
  
  CONCLUSIONS
  In CKD patients, CCA-IMT examination can be used as a surrogate measure to assess the incidence and severity of arterial medial calcification which is associated with poor clinical outcome in these patients.
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. kasiajanda@op.pl.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Janda
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. mkrzanowski@op.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Krzanowski
authors.affiliation: Chair and Department of Histology, Jagiellonian University, Medical College, Cracow, Poland. mmgajda@cyf-kr.edu.pl.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gajda
authors.affiliation: Department of Medical Diagnostics, Jagiellonian University, Medical College, Cracow, Poland. paulina.dumnicka@uj.edu.pl.
authors.forename: Paulina
authors.initials: P
authors.lastname: Dumnicka
authors.affiliation: Chair of Clinical Biochemistry, Jagiellonian University, Medical College, Cracow, Poland. danuta.fedak@uj.edu.pl.
authors.forename: Danuta
authors.initials: D
authors.lastname: Fedak
authors.affiliation: Chair and Department of Histology, Jagiellonian University, Medical College, Cracow, Poland. mmlis@cyf-kr.edu.pl.
authors.forename: Grzegorz J
authors.initials: GJ
authors.lastname: Lis
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. jaskowskip@interia.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Jaśkowski
authors.affiliation: Radioligand Laboratory, Faculty of Pharmacy, Jagiellonian University, Medical College, Cracow, Poland. apietrzy1@cm-uj.krakow.pl.
authors.forename: Agata
authors.initials: A
authors.lastname: Pietrzycka
authors.affiliation: Chair and Department of Histology, Jagiellonian University, Medical College, Cracow, Poland. mmlitwin@cyf-kr.edu.pl.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Litwin
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. wladsul@mp.pl.
authors.forename: Władysław
authors.initials: W
authors.lastname: Sułowicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D003324:Coronary Artery Disease; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007249:Inflammation; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D015675:Osteocalcin / Q000378:metabolism; D053495:Osteopontin / Q000378:metabolism; D053244:Osteoprotegerin / Q000378:metabolism; D018384:Oxidative Stress; D017534:Radial Artery / Q000473:pathology*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic; D018570:Risk Assessment; D000683:Serum Amyloid P-Component / Q000378:metabolism; D012720:Severity of Illness Index; D017540:Tunica Media / Q000473:pathology*; D061205:Vascular Calcification / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism; D000099153:Pentraxins
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors; D015850:Interleukin-6; D015675:Osteocalcin; D053495:Osteopontin; D053244:Osteoprotegerin; D000683:Serum Amyloid P-Component; D060749:alpha-2-HS-Glycoprotein; D000099153:Pentraxins; C508600:IL6 protein, human; C506030:TNFRSF11B protein, human