Introduction:
Chronic kidney disease patients have high cardiovascular morbidity and mortality. Atherosclerotic changes are a major contributor to it. Carotid intima media thickness (CIMT) can be measured and used as a surrogate maker for assessment of atherosclerosis. It can predict the onset and progression of cardiovascular disease with reasonable accuracy. Renal transplantation significantly improves the quality of life of patients with end stage renal disease on dialysis. Thus it is increasingly becoming a preferred modality for renal replacement therapy. This study was done to investigate the improvement of carotid intima media thickness and thus vascular atherosclerosis in patients who undergo renal transplant.
Methods:
The study involved 80 chronic kidney disease patients who were on maintenance hemodialysis and underwent renal transplantation. Carotid intima media thickness was measured by ultrasound. Intima media thickness was taken as distance between leading edge of first echogenic line (lumen intimal interface) and second echogenic line (medial adventitia interface). The measurements were taken at 0.5 cm, 1 cm and 2 cm below bifurcation of common carotid artery on both sides (left and right) at time of renal transplantation followed by repeat measurements at 1 year post renal transplant. Each time, the mean average value of CIMT was calculated for both sides individually followed by calculation of the mean average value of CIMT of both sides together. The CIMT value (mean average value of both sides together) at 1 year post renal transplant was then compared with the CIMT value (mean average value of both sides together) at the time of transplant. Laboratory values for chronic kidney disease-mineral bone disorder (CKD-MBD) parameters -Calcium, Phosphorus, Vitamin D and PTH along with spot urine protein creatinine ratio were evaluated at time of renal transplant followed by repeat evaluation of these parameters after 1 year post renal transplant. Correlation between changes in these CKD-MBD parameters with change in CIMT was assessed after one year post transplant.
Results:
CIMT was found to be significantly decreased at one year post renal transplant as compared to CIMT value at the time of transplant. The CIMT value after 1 year post transplant was 0.61 mm which was significantly lower than the CIMT value at time of transplant (0.68 mm) with p value < 0.0001. Patients had significant improvement in CKD-MBD parameters (Calcium, Phosphorus, Vitamin D and PTH) (p value < 0.0001) and spot urine protein creatinine ratio (p value < 0.0001) after 1 year of renal transplant . However no significant correlation was seen between the changes in CKD-MBD parameters with change in CIMT after 1 year post renal transplant.
Conclusions:
There is improvement in cardiovascular risk factors profile post renal transplantation with subsequent decrease in cardiovascular diseases . Our study also suggested the same as significant lowering of CIMT was observed in renal transplant recipients thus decreasing the atherosclerosis and cardiovascular diseases.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.