INTIMA-MEDIA THICKNESS AS AN EARLY MARKER OF ATHEROSCLEROSIS IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Andreja Figurek1,2, Snjezana Popovic-Pejicic3,2, Vlastimir Vlatkovic1,2, Maja Travar4,5
1Department of Nephrology, University Clinical Centre of the Republic of Serpska, Banja Luka, Bosnia and Herzegovina
2The Faculty of Medicine, University of Banja Luka
3Department of Endocrinology, University Clinical Centre of the Republic of Serpska, Banja Luka, Bosnia and Herzegovina
4The Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
5Department for Microbiology, University Clinical Centre of the Republic of Serpska
Keywords: atherosclerosis, cardiovascular disease, chronic kidney disease, intima-media thickness
Abstract
Objectives. The prevalence of chronic kidney disease (CKD) rises worldwide due to the aging of global population and higher frequency of diabetes mellitus. Patients with CKD have many complicationts and comorbidities that affect the duration and quality of their life. Early atherosclerosis process can be assessed by measuring carotid intima-media thickness (IMT). The aim of this study was to assess the frequency of atherosclerotic process in patients with various CKD stages by using ultrasound, as harmless and cheap way that can be performed in everyday clinical practice. Material and methods. This cross-sectional study included 87 patients of all stages of chronic kidney disease. Mean estimated glomerular filtration rate was 40.1 (3-110) mL/min/1.73 m2. IMT was measured at 10 mm of the common carotid arteries bifurcation. Methods of desciptive statistics, Pearson correlation coefficient, multiple linear regression and t-test were used to analyze data obtained from the study. Results. The mean value of IMT average was 1.10 ± 0.20 mm (minimum 0.70 mm, maximum 2.00 mm) and 56 out of 87 patients (64.37 %) had plaques in carotid arteries. Patients age, calcium phosphate product, creatinine level and creatinine clearance correlated significantly with both, IMT and the presence of plaque in carotid artery. IMT was significantly associated with parathyroid hormone level ( r = 0.238, p = 0.026). Conclusion. IMT is increased from early stages of CKD following the worsening of kidney function. Color doppler ultrasound of carotid arteries and measurement of IMT is of great importance in assessment of early atherosclerotic process development and cardiovascular risk estimation in patients with CKD.
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