A study of atherosclerosis in patients with chronic renal failure with special reference to carotid artery intima media thickness

Abstract

Objectives: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic renal failure (CRF). This study attempts to identify the factors responsible for atherosclerosis in CRF patients using carotid artery intima media thickness (CAIMT) as a surrogate marker of atherosclerosis.

Materials and methods: CAIMT was measured by high-resolution B-mode ultrasonography in 100 CRF patients and 50 age- and sex-matched healthy controls. Data were analyzed by software SPSS (17(th) version) for Windows.

Results: CRF patients had a significantly higher CAIMT (1026.83 ± 17.19 micron, mean ± SE, P < 0.001) than age- and sex-matched healthy controls (722.46 ± 7.61 micron). There was inverse correlation between CAIMT and glomerular filtration rate (GFR) (P < 0.001) independent of traditional risk factors. There was also significant positive correlation between CAIMT and traditional risk factors of atherosclerosis. Ischemic heart disease (IHD) also showed positive correlation with CAIMT (P = 0.007) and inverse correlation with GFR (P = 0.005).

Conclusions: There is high prevalence of atherosclerosis in CRF patients. CAIMT can be used to detect and predict future incidence of IHD in CRF patients.

Keywords: Atherosclerosis; carotid artery intima media thickness; chronic renal failure; ischemic heart disease; traditional risk factors of atherosclerosis.

Figure 1

Measurement of intima media thickness at right carotid bifurcation (RT CC BULB) and right common carotid artery (RT CCA)

Figure 2

Comparison of CAIMT of different groups of CRF patients