Carotid Intima-Media Thickness as a Cardiovascular Risk Factor in Patients with Chronic Kidney Disease

Abstract

Abstract Background Atherosclerosis is a systemic arterial disease which frequently involve multiple vascular beds. Etiologically, cases of atherosclerosis occurring in different arterial vascular beds may share the same set of traditional risk factors. Aim of the Work In this present study we aimed to- evaluate the effect of chronic kidney disease on carotid intima media thickness as a cardiovascular risk factor in these patients. Patients and Methods This is a Case-control study conducted at Ain shams university hospitals during the period between January 2022 and June 2022. Results We found that patients with chronic kidney disease had significantly higher values of carotid intima media thickness (mean value of 1.10± 0.16 mm) versus control group (mean value of 0.49± 0.15mm).Also we noticed that with progression of kidney disease carotid intima media thickness (CIMT) becomes higher.CIMT showed a trend of gradual increase with decreased eGFR.Also we found that CIMT correlated positively with age, blood pressure, serum reatinine, urea and total cholesterol, but negatively with eGFR and we found that patients with diabetes and hypertension had CIMT higher than patients without diabetes and hypertension.The ROC curve analysis showed that the AUC for using eGFR cut off value of ≤ 75 mL/min for predicting CIMT thickness (>0.7 mm) was 1.And both the specificity and Sensitivity of eGFR in predicting CIMT thickening to be 100%. Conclusion Carotid IMT is significantly increased in Chronic kidney disease patients and may be usefully applied for risk stratification in this group of patients.Our study shows that, eGFR (≤ 75ml/min) has a positive predictive value for CIMT thickness(>0.7mm) with specificity and sensitivity 100%.