Atherosclerosis progression in chronic kidney disease

HERNAN A PERÉZ ; DANIELA J. PORTA; MARIANA CARILLO; LAURA ABALLAY; SONIA EDITH MUÑOZ; LUIS J ARMANDO; J DAVID SPENCE; NESTOR H GARCIA

New Orleans

Congreso; Spring Clinical Meetings 2020 National Kidney Foundation; 2020

National Kidney Foundation

Cardiovascular event (CVE) rate is high in patients with chronic renal failure (CRF), but the underlying mechanisms are incompletely understood. Classical cardiovascular risk factors (RF) do not explain the increased risk, and studies observed paradoxical or absent associations between classical RF and mortality in CRF patients. Controlled trials did not shown systematically that statin therapy in CRF reduce CVE. This may be the result of accelerated atherosclerosis (ATC). Quantification of subclinical ATC can be evaluated very accurately and non- invasively by carotid total plaque area (TPA). Objective: We investigated the relation of TPA and renal function in controls (GI), Stage 2 (GII), Stage 3 (G3) and Stage 4 (G4) CRF. Additionally, we also evaluated the association of classical RF and the progression of the TPA. Methods: A cohort study in 331 patients was performed. Participants consented to a protocol approved by ethics committee. Clinical, laboratory tests and TPA were determined at time 0 and after 1 year. TPA was measured using carotid ultrasonography. Renal function was determined by MDRD equation 4. ANOVA and a multivariate generalized linear model with gamma distribution and log link function analysis were used when appropriate