Carotid Artery Intima–Medial Thickness Is Increased In Chronic Renal Failure

Abstract

1. Chronic renal failure (CRF) is associated with rapidly progressive atherosclerotic vascular disease. In the present study, carotid arterial intima-medial thickness (IMT) was assessed in a large cohort of patients with CRF and matched controls and related to risk factors. 2. A total of 159 subjects with CRF (serum creatinine > or =0.40 mmol/L) aged > 50 years (mean (+/-SD) 63.8+/-7.7 years) and 159 healthy controls matched for age, sex and smoking status were studied. 3. The IMT was determined using B-mode ultrasound measurements of the far wall of both common carotid arteries and presented as the mean IMT. Fasting plasma homocysteine (tHcy) was measured in the CRF group. 4. Intima-medial thickness was significantly greater in CRF patients than controls (0.89+/-0.17 vs 0.73+/-0.13 mm, respectively) after matching for age, sex and smoking status. Heart rate and pulse pressure were also significantly increased. The tHcy was increased two-fold in the CRF group (27.7+/-11.3 micromol/L; normal < 13.0 micromol/L) and did not correlate with carotid IMT. 5. Compared with controls after adjusting for traditional risk factors, patients with CRF exhibit significantly increased IMT.

Mild Renal Insufficiency Is Associated With Angiographic Coronary Artery Disease in Women

“…[7][8][9] However, generalization of our results from a female cohort with chest pain to the population at large is limited. The association between renal insufficiency and cardiovascular pathophysiology may be gender-dependent.…”

“…These results extend observations that declining renal function is associated with subclinical atherosclerosis (vascular stiffness, brachial artery endothelial dysfunction, carotid artery intima-media thickening). [7][8][9] They also offer biological rationale for the previously reported finding that mild-moderate renal insufficiency (creatinine Ն1.2 mg/dL) is associated with an increased risk for cardiovascular events in women with CAD. 2 The pathophysiological mechanism for the association between mild renal insufficiency and angiographic CAD is uncertain.…”

Impact of diabetes and glycaemic control on peripheral artery disease in Japanese patients with end-stage renal disease: long-term follow-up study from the beginning of haemodialysis

“…In patients with renal dysfunction, there is a strong association between this condition and systemic atherosclerosis [20][21][22]. Uraemia-related risk factors including haemodynamic overload and abnormal calcium metabolism greatly impact on arteriosclerosis [23].…”

Cystatin C and Subclinical Brain Infarction

“…Impaired renal function is increasingly being recognized as an important and highly prevalent vascular risk factor associated with an increased risk for cerebrovascular disease. Previous reports have found both renal insufficiency and ESRD to be associated with an increased risk for clinical stroke (8 -12) and subclinical carotid artery atherosclerosis (13)(14)(15)(16)(17)(18)(19). Consequently, the estimated 8 million individuals in the United States with decreased renal function may also be at increased risk for SBI and its associated morbidity.…”