Atherosclerosis progression in chronic kidney disease.

PORTA DJ; MUNOZ SE; GARCÍA NH; CARRILLO MN; ARMANDO MJ; PEREZ HA; ABALLAY LR; SPENCEJD

Atlanta

Encuentro; NKF 2020 Spring Clinical Meetings; 2020

IntroductionCardiovascular event (CVE) rate is high inpatients with chronic renal failure (CRF), but the underlying mechanisms areincompletely understood. Classical cardiovascular risk factors (RF) do notexplain the increased risk, and studies observed paradoxical or absentassociations between classical RF and mortality in CRF patients. Controlledtrials did not shown systematically that statin therapy in CRF reduce CVE. Thismay be the result of accelerated atherosclerosis (ATC). Quantification ofsubclinical ATC can be evaluated very accurately and non-invasively by carotidtotal plaque area (TPA). Thus, we investigated the relation of TPA and renalfunction in controls (G1, n=56), Stage 2 (G2, n=211), Stage 3 (G3, n=118) andStage 4 (G4, n=16) CRF. Additionally, we also evaluated the association ofclassical RF and the progression of the TPA.  MethodsParticipants consented to a protocol approvedby ethics committee. Clinical, laboratory tests and TPA were determined at time0 and after 1 year. TPA was measured using carotid ultrasonography. Renalfunction was determined by MDRD equation 4. ResultsG1 (age 61±2 yo) had eGFR103±2 ml/min, bloodpressure (BP) 131±2/77±1 mmHg, body mass index (BMI) 32±1 kg/m2,LDL87±7 mg/dl, HbA1c 6.7±0.2% and the lowest TPA 64±8 mm2. G2 (59±1yrs) had eGFR72±1 ml/min, BP 134±1/78±1 mmHg, BMI 31,3±0,4 kg/m2,LDL72±4 mg/dl, HbA1c 6.2±0.1% and TPA 71±6mm2, G3 (66±1 yrs) hadeGFR50±1 ml/min, BP 135±2/77±1 mmHg, BMI 30,1±0,4 kg/m2, LDL81±4mg/dl, HbA1c 6.4±0.1% and TPA 105±10mm2 (p