INICSA   23916
INSTITUTO DE INVESTIGACIONES EN CIENCIAS DE LA SALUD
Unidad Ejecutora - UE
congresos y reuniones científicas
Título:
TOTAL PLAQUE AREA IN CHRONIC RENAL FAILURE
Autor/es:
LUIS J. ARMANDO; NESTOR H. GARCIA; HERNAN A. PEREZ
Lugar:
Seul
Reunión:
Congreso; The 26th Scientific Meeting of the International Society of Hypertension; 2016
Institución organizadora:
International SOciety of Hypertension
Resumen:
Background and aims Cardiovascular disease rates are very high in patients with renal disease, but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in chronic renal failure do not reduce cardiovascular events. These results may be the results of ?accelerated atherosclerosis? observed on these patients.The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with impaired kidney function. We studied a cohort of patients with chronic kidney disease not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease.Methods: Design, setting, participants, & measurements: We performed a cohort study in 412 patients with Stage 1, 2 and 3 chronic renal failure (CRF). Baseline clinical and laboratory data were obtained on all patients. Carotid total plaque area was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease (MDRD) estimation formula was used to determine renal function. The study was approved by the Blossom DMO Argentina ethics committee and informed consent from each participant were obtained. ANOVA was used when appropriate.Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 ( p< 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that carotid total plaque area increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be use to measure effects of antiatherosclerotic therapy