title: Mineral metabolism factors predict accelerated progression of common carotid intima-media thickness in chronic kidney disease: the NEFRONA study.
abstract: BACKGROUND
  The leading cause of premature death in chronic kidney disease (CKD) is cardiovascular disease (CVD), but risk assessment in renal patients is challenging. The aim of the study was to analyse the factors that predict accelerated progression of common carotid intima-media thickness (CCIMT) in a CKD cohort after 2 years of follow-up (2010-12).
  
  
  METHODS
  The study included 1152 patients from the NEFRONA cohort with CKD stages 3-5D and without a clinical history of CVD. CCIMT was measured at the far wall on both common carotids. CCIMT progression was defined as the change between CCIMT at baseline and at 24 months for each side, averaged and normalized as change per year. Accelerated progressors were defined as those with a CCIMT change ≥75th percentile.
  
  
  RESULTS
  The median CCIMT progression rate was 0.0125 mm/year, without significant differences between CKD stages. The cut-off value for defining accelerated progression was 0.0425 mm/year. After adjustment, age was a common factor among all CKD stages. Traditional cardiovascular risk factors, such as diabetes and systolic blood pressure, were predictors of progression in CKD stages 4-5, whereas high-density lipoprotein and low-density lipoprotein cholesterol predicted progression in women in stage 3. Mineral metabolism factors predicting accelerated progression were serum phosphorus in stages 3 and 5D; low 25-hydroxyvitamin D and parathyroid hormone levels >110 pg/mL in stages 4-5 and intact parathyroid hormone levels out of the recommended range in stage 5D.
  
  
  CONCLUSIONS
  Mineral metabolism parameters might predict accelerated CCIMT progression from early CKD stages.
authors: Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain.
authors: Maria
authors: M
authors: Abajo
authors: Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain.
authors: Àngels
authors: À
authors: Betriu
authors: Department of Nephrology, Hospital Universitario Arnau de Vilanova, Lleida, Spain.
authors: David
authors: D
authors: Arroyo
authors: Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain.
authors: Marta
authors: M
authors: Gracia
authors: Department of Nephrology, Hospital Torrecárdenas, Almeria, Spain.
authors: Mª Dolores
authors: MD
authors: Del Pino
authors: Department of Nephrology, Hospital de Galdakao, Bilbao, Spain.
authors: Isabel
authors: I
authors: Martínez
authors: Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain.
authors: Jose M
authors: JM
authors: Valdivielso
authors: Nephrology Research Department, Biomedical Research Institute of Lleida (IRBLleida) and REDINREN, Edificio Biomedicina 1. Lab B1-10, Rovira Roure 80, Lleida 25198, Spain.|Department of Nephrology, Hospital Universitario Arnau de Vilanova, Lleida, Spain.
authors: Elvira
authors: E
authors: Fernández
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D001794:Blood Pressure; D002118:Calcium / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D018570:Risk Assessment; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; C104450:25-hydroxyvitamin D; D002118:Calcium
keywords: atheromatosis progression; intima-media thickness; parathyroid hormone; phosphorus; vitamin D