Chronic kidney disease and carotid atherosclerosis

Chronic kidney disease is an independent risk factor for cardiovascular disease. The association between carotid intima-media thickness (IMT) and chronic kidney disease is controversial, however. In addition, whether renal dysfunction promotes vascular calcification in patients with chronic kidney disease is not clear. The study subjects were 1003 patients aged ≥50 years who underwent carotid ultrasonography in our hospital. Kidney function was evaluated based on the estimated glomerular filtration rate (eGFR) and the presence of proteinuria. Patients with end-stage renal failure were excluded. We measured the mean max-IMT (which indicates mean maximal wall thickness) at 12 carotid segments, and examined the characteristics of the maximal plaques by carotid ultrasonography. We evaluated the association between mean max-IMT and eGFR, and also evaluated the clinical factors associated with mean max-IMT and calcification of the maximal plaques. We found that eGFR was significantly correlated with mean max-IMT. Reduced eGFR, proteinuria, age, male sex, cardiovascular disease, hypertension, diabetes, and smoking were independently associated with mean max-IMT in multiple regression analysis. Kidney function was not associated with calcified plaque. Kidney dysfunction was associated with carotid atherosclerosis in patients with mild or moderate chronic kidney disease.