Abstract
Background: Chronic kidney disease (CKD) is associated with accelerated atherosclerosis and an increased risk of adverse cardiovascular disease (CVD) outcomes. The relationships of intima-media thickness (IMT), a measure of subclinical atherosclerosis, with traditional and nontraditional risk factors and with adverse outcomes in CKD patients are not well-established. Methods: IMT, clinical characteristics, cardiovascular risk factors, and clinical outcomes were measured in 198 subjects from the Renal Research Institute (RRI) CKD study, a four-center prospective cohort of patients with estimated glomerular filtration rate (eGFR) ≤ 50 mL/min/1.73 m2 not requiring renal replacement therapy. Results: The patients averaged 61 ± 14 years of age; the mean eGFR was 29 ± 12 mL/min/1.73 m2. Maximum IMT was more closely associated with traditional cardiovascular risk factors, including age, diabetes, dyslipidemia, and systolic blood pressure, than with nontraditional risk factors or with eGFR. Higher values of maximum IMT were also independently associated with clinical CVD and with other markers of subclinical CVD. Maximum IMT ≥ 2.6 mm was predictive of the composite endpoint of CVD events and death (hazard ratio (HR): 5.47 (95% confidence interval (CI): 2.97 – 10.07, p < 0.0001)) but was not related to progression to end-stage renal disease (HR: 1.67 (95% CI: 0.74 – 3.76, p = 0.21)). Conclusion: In patients with advanced pre-dialysis CKD, higher maximum IMT was associated with traditional cardiovascular risk factors, CVD, and other markers of subclinical CVD and was an independent predictor of cardiovascular events and death. Additional research is needed to examine the clinical utility of IMT in the risk stratification and clinical management of patients with CKD.
Highlights
Chronic kidney disease (CKD) is associated with an increased risk of adverse cardiovascular disease (CVD) outcomes
We examined carotid intima-media thickness (IMT) in patients with advanced pre-dialysis CKD enrolled in the Renal Research Institute (RRI)-CKD study to 1) assess the relationships between
The principal findings of our study include the following: 1) patients in our cohort with advanced CKD had a high prevalence of coronary risk factors and clinical CVD; 2) IMT was more closely associated with traditional cardiovascular risk factors, such as age, diabetes, dyslipidemia, systolic blood pressure (BP), and tobacco use, than with nontraditional risk factors or with estimated glomerular filtration rate (eGFR); 3) higher IMT was associated with clinical CVD and with other markers of subclinical disease; and 4) higher IMT predicted cardiovascular events, independent of traditional and nontraditional risk factors and prevalent CVD
Summary
Chronic kidney disease (CKD) is associated with an increased risk of adverse cardiovascular disease (CVD) outcomes. Indicate that the relationships between estimated glomerular filtration rate (eGFR) and CVD morbidity, and mortality are independent of these characteristics [14, 15, 16]. These observations have led to the suggestion that “nontraditional” risk factors, IMT and traditional risk factors, nontraditional risk factors, and other markers of subclinical CVD; and 2) evaluate the relationship of subclinical atherosclerosis to adverse clinical outcomes in this population. We hypothesized that IMT would be correlated with both traditional and nontraditional CVD risk factors as well as other markers of cardiac disease, and would predict both cardiovascular events and progression to end-stage renal disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
