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Updated: Aug 14, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Assessment of atherosclerosis and endothelial dysfunction risk factors in patients with primary glomerulonephritis
Rodrigo Hagemann1,2, Marcela Tatiana Watanabe1, João Carlos Hueb1
1Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Clínica Médica, Botucatu, São Paulo, Brazil.
Insights
Patients with primary glomerulonephritis (PG) show increased atherosclerosis markers like carotid intima-media thickness (CIMT). Early mineral and bone disorder (MBD) did not explain this heightened cardiovascular risk in PG patients.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Glomerulonephritis is a leading cause of chronic kidney disease (CKD) and dialysis in Brazil.
- Mineral and bone disorder (MBD) is a common complication of CKD, present even in early stages.
- Assessing carotid intima-media thickness (CIMT) and flow-mediated vasodilatation (FMV) offers non-invasive cardiovascular risk evaluation.
Purpose of the Study:
- To investigate the prevalence of atherosclerosis markers in patients with primary glomerulonephritis (PG).
- To explore the potential influence of early mineral and bone disorder (MBD) on cardiovascular risk in PG patients.
Main Methods:
- A cross-sectional, observational, and controlled study design was employed.
- Patients with primary glomerulonephritis (PG) were included, with specific exclusion criteria for age, follow-up duration, secondary causes, proteinuria, and corticosteroid use.
- Carotid intima-media thickness (CIMT) and flow-mediated vasodilatation (FMV) were assessed using ultrasound.
Main Results:
- Patients with PG exhibited significantly higher mean CIMT compared to controls (0.66 vs. 0.60, p = 0.003).
- Multivariate analysis identified age, systolic blood pressure (SBP), FMV, and glomerular filtration rate (GFR) as statistically relevant factors (p = 0.02).
- FMV and serum uric acid also remained statistically significant (p = 0.048).
Conclusions:
- The elevated cardiovascular risk observed in primary glomerulonephritis (PG) patients was not attributable to early mineral and bone disorder (MBD).
- Further randomized, multicentric clinical studies are warranted to validate these findings and explore the underlying mechanisms.
Introduction:
Glomerulonephritis are the third cause of chronic kidney disease (CKD) requiring dialysis in Brazil. Mineral and bone disorder (MBD) is one of the complications of CKD and is already present in the early stages. Assessment of carotid intima-media thickness (CIMT) and flow-mediated vasodilatation (FMV) are non-invasive ways of assessing cardiovascular risk.
Hypothesis:
Patients with primary glomerulonephritis (PG) have high prevalence of atherosclerosis and endothelial dysfunction, not fully explained by traditional risk factors, but probably influenced by the early onset of MBD.
Objective:
To evaluate the main markers of atherosclerosis in patients with PG.
Method:
Clinical, observational, cross-sectional and controlled study. Patients with PG were included and those under 18 years of age, pregnants, those with less than three months of follow-up and those with secondary glomerulonephritis were excluded. Those who, at the time of exams collection, had proteinuria higher than 6 grams/24 hours and using prednisone at doses higher than 0.2 mg/kg/day were also excluded.
Results:
95 patients were included, 88 collected the exams, 1 was excluded and 23 did not undergo the ultrasound scan. Patients with PG had a higher mean CIMT compared to controls (0.66 versus 0.60), p = 0.003. After multivariate analysis, age and values for systolic blood pressure (SBP), FMV and GFR (p = 0.02); and FMV and serum uric acid (p = 0.048) remained statistically relevant.
Discussion And Conclusion:
The higher cardiovascular risk in patients with PG was not explained by early MBD. Randomized and multicentric clinical studies are necessary to better assess this hypothesis.
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