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Carotid Intima-Media Thickness: A Surrogate Marker for Cardiovascular Disease in Chronic Kidney Disease Patients
Olutoyin Morenike Lawal1, Michael Olabode Balogun2, Anthony Olubunmi Akintomide2
1Department of Medicine, State Specialist Hospital, Akure, Nigeria.
Insights
Patients with chronic kidney disease (CKD) show significantly higher carotid intima-media thickness (CIMT), a marker of atherosclerosis. Early CIMT assessment in CKD patients may help identify those needing aggressive treatment for cardiovascular disease (CVD).
Area of Science:
- Nephrology
- Cardiology
- Vascular Medicine
Background:
- Cardiovascular disease (CVD) is the primary cause of death in chronic kidney disease (CKD) patients.
- Carotid intima-media thickness (CIMT) reflects atherosclerotic vascular disease and cumulative effects of cardiovascular risk factors on arterial walls.
- This study aimed to assess CIMT in CKD patients and evaluate CVD prevalence and clinical patterns.
Purpose of the Study:
- To determine the carotid intima-media thickness (CIMT) in patients with chronic kidney disease (CKD).
- To evaluate the clinical pattern and prevalence of cardiovascular disease (CVD) in CKD patients.
Main Methods:
- A case-control study included 50 patients with CKD (stages 2-4) and 50 matched healthy controls.
- Carotid intima-media thickness (CIMT) was measured; >0.8 mm defined thickening.
- Laboratory tests, ECG, echocardiography, and ankle-brachial index were performed on all participants.
Main Results:
- Mean CIMT was significantly higher in CKD patients versus controls (P < .001).
- Eighty-four percent of CKD patients had thickened CIMT compared to 18% of controls (P < .001).
- CKD patients exhibited higher blood pressure, heart rate, and CVD prevalence. CIMT correlated positively with age, blood pressure, and blood sugar.
Conclusions:
- Carotid intima-media thickness (CIMT) is a reliable surrogate marker for cardiovascular disease (CVD) in chronic kidney disease (CKD) patients.
- Early CIMT assessment can identify CKD patients requiring intensified therapy to slow kidney disease progression and improve outcomes.
Background:
Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD). Carotid intima-media thickness (CIMT) is a measure of atherosclerotic vascular disease and considered a comprehensive picture of all alterations caused by multiple cardiovascular risk factors over time on the arterial walls. We therefore sought to determine the CIMT of the common carotid artery in patients with CKD and to evaluate the clinical pattern and prevalence of CVD in CKD patients.
Methods:
A case-control study involving 100 subjects made of 50 patients with CKD stages 2 to 4 and 50 age and sex matched apparently normal individuals. Carotid intima-media thickness of the common carotid artery was considered thickened if it measured greater than 0.8 mm. All subjects had laboratory investigations, 12-lead electrocardiogram, transthoracic echocardiography, and ankle-brachial index.
Results:
The mean CIMT was higher in CKD population compared with controls (P < .001). Eighty-four percent of the study population was found to have thickened CIMT compared with 18% of controls (P < .001). Patients with CKD had significantly higher blood pressure and heart rate than controls. Cardiovascular disease was also more prevalent among patients with CKD as compared with controls. Carotid intima-media thickness positively correlated with age, blood pressure, and random blood sugar.
Conclusions:
As CIMT was well correlated with many cardiovascular risk factors among CKD patients, it may serve as a surrogate marker for CVD and its early assessment may target patients who may need more aggressive therapy to retard the progression of kidney disease and improve outcome.
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