Narrative Review of Carotid disease and the kidney

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Vascular Biology

Background:

• Patients with chronic kidney disease (CKD) exhibit elevated cardiovascular (CV) risk, partially unexplained by traditional factors.
• Carotid arteriosclerosis and atherosclerosis are prevalent in CKD, contributing to CV disease and potentially impacting renal disease progression.
• Arterial stiffening is detectable even in early stages of reduced glomerular filtration rate (GFR), while thickening occurs in later stages.

Purpose of the Study:

• To review the arterial phenotype in patients with CKD.
• To discuss the consequences of carotid dysfunction and arterial stiffening in CKD.
• To explore therapeutic strategies for improving carotid function in CKD patients.

Main Methods:

• Review of existing literature on arterial properties in CKD patients.
• Analysis of functional and structural alterations in the arterial wall.
• Discussion of the link between arterial stiffness and target organ damage (brain, kidney, heart).

Main Results:

• The arterial phenotype in CKD is characterized by increased common carotid artery stiffness with outward remodeling.
• Muscular arteries show normal/reduced stiffness with inward remodeling.
• Arterial stiffness mediates CKD's impact on target organs.

Conclusions:

• CKD is associated with distinct arterial changes, including carotid artery stiffening and remodeling.
• Carotid dysfunction contributes to increased cardio- and cerebrovascular risk in CKD.
• Therapeutic interventions targeting carotid function may improve outcomes in CKD patients.