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There are multiple factors related to cardiovascular disease in individuals with CKD. Traditionally, risk factors with high prevalence, such as hypertension, dyslipidemia, DM and smoking are found associated with non-traditional factors, such as inflammation, oxidative stress, albuminuria and hyperphosphatemia, which seem to play a relevant role in the accelerated development of the atherosclerotic process in kidneys. chronic. The present study investigated the relationship between carotid and coronary atherosclerosis in a group of patients with non-dialysis CKD.
This study is part of a cohort with non-dialysis chronic kidney disease patients monitored for 3 years. From the database, a cross-section was carried out including 128 patients from whom clinical, laboratory and imaging data were collected. All patients underwent carotid Doppler to measure carotid intima-media thickness (CIMT), coronary tomography to evaluate the calcium score (ECC) and evaluation of the ankle-brachial index (ABI). Differences between numerical variables were evaluated using the t-test or Mann-Whitney and categorical variables using Chi-square. Correlations were evaluated using Spearman's coefficient.
The median CIMT was 0.8mm, with 42.9% of patients presenting levels above this value. The mean age was higher in the group of patients with CIMT >0.8mm, 65.4 (6.4) years (p<0.001), as well as a higher prevalence of males (53.4%, p=0.160) in this sub-group of patients. Diabetes mellitus (p=0.007) and the mean value of systolic blood pressure (p=0.007) were associated with the highest median CIMT. Patients with CIMT >0.8mm had an even higher mean calcium score, 291.2 (708.7) vs 116.7 (332.9), with p<0.001. A positive correlation between CIMT and age (r=0.51, p<0.001), SBP (r=0.34, p<0.001), ABI (r=0.26, p=0.03) and BCS (r=0.34, p<0.001) was identified. No association was observed between CIMT and laboratory variables associated with dyslipidemia, BMD, anemia and albuminuria.
In this sample of patients with non-dialysis CKD, an association between atherosclerotic disease was observed only with traditional risk factors for cardiovascular disease. The positive and statistically significant correlation between the three atherosclerosis markers evaluated stands out: CIMT, ECC and ABI.