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Morphology of coronary atherosclerotic lesions in patients with end-stage renal failure

U Schwarz1, M Buzello, E Ritz

  • 1Department of Internal Medicine, Heidelberg, Germany.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 29, 2000
PubMed

Insights

Patients with end-stage renal failure have more calcified coronary plaques with increased media thickness. These differences in plaque composition, not size, may explain higher cardiac death rates in renal failure patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pathology

Background:

  • End-stage renal failure (ESRF) is associated with increased cardiac mortality.
  • Coronary heart disease (CHD) is prevalent in ESRF patients.
  • The natural history of coronary plaque in ESRF may differ from non-uraemic individuals.

Purpose of the Study:

  • To assess coronary artery morphology in ESRF patients.
  • To compare coronary plaque characteristics between ESRF and non-uraemic patients.

Main Methods:

  • Autopsy analysis of coronary arteries from 27 ESRF patients and 27 matched controls.
  • Qualitative and quantitative plaque analysis (Stary classification, planimetry).
  • Immunohistochemical analysis and X-ray diffraction of calcified plaques.

Main Results:

  • ESRF patients exhibited significantly more calcified coronary plaques.
  • Coronary arteries in ESRF patients showed increased media thickness and smaller lumen area.
  • Plaque composition, specifically increased calcification, differed significantly, while plaque size was comparable.

Conclusions:

  • Coronary plaques in ESRF are characterized by increased calcification and media thickness.
  • Plaque composition, not size, is the primary difference between ESRF and non-uraemic patients.
  • Increased plaque calcification in ESRF may contribute to higher cardiovascular complication rates.
Abstract

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