A Study on Carotid Intima-Media Thickness and Ankle Brachial Index In Patients with Various Stages of Chronic Kidney Disease

Abstract

The presence of peripheral vascular disease in chronic kidney disease portends a dismal prognosis due to the increased morbidity and mortality from cardiovascular events. Peripheral vascular disease is asymptomatic in about 40%. The study was designed to identify the prevalence of the peripheral vascular disease in chronic kidney disease, which is a state of accelerated atherosclerosis. A sample of 90 patients of chronic kidney disease attending the outpatient department in medicine and nephrology were assessed for the prevalence of peripheral vascular disease by measuring the Ankle-brachial index and Carotid intima-media thickness. Gender, smoking, hypertension, diabetes and ischemic heart disease profiles of the sample were analyzed for association with peripheral vascular disease. Majority of the patients belonged to the age group 40-50 years. 82 were males, of these 47 were smokers. 6 patients in the sample had symptoms suggestive of peripheral vascular disease. While 21%(n=19) of patients in the sample were diabetics and 21%(n=19) had evidence of ischemic heart disease, hypertension was present in 41%(n=37) of the patients. 50% of the patients belonged to CRF stage 4. The prevalence of the peripheral vascular disease, as determined by ABI<0.9, was 31.1%. CIMT thickness > 0.9mm has a positive correlation with CKD stages and has a statistically significant P value of <0.05. In conclusion, this study revealed that there is an increased prevalence of PVD in smokers, diabetics and in ischemic heart disease compared to those with hypertension.