[Evaluation of intima-media thickness in patients with chronic kidney disease not on dialysis: a prospective study of 24 months]

Abstract

Introduction: Increased carotid intima-media thickness (IMT) is considered a marker of early-onset atherosclerosis and it seems to predict cardiovascular events in general population. The prognostic value of IMT in patients with early-stage chronic kidney disease (CKD) has not been clearly established.

Objective: We aimed to evaluate the association between IMT and cardiovascular (CV) events and mortality in CKD patients.

Methods: A cohort of CKD patients in stage 2-4 was evaluated the occurrence of CV events and death in a 24 months follow-up. Laboratory data, carotid ultrasound and coronary computed tomography were performed at baseline.

Results: A total of 117 patients (57 ± 11 years-old, 61% male) were evaluated. Mean glomerular filtration rate (eGFR) was 36 ± 17 mL/min, 96% of patients had hypertension, 23% diabetes and 27% were obese. Coronary calcification was found in 48% of the patients, with higher prevalence among CKD stage 4 (p = 0.02). The median value of IMT was 0.6 mm (0.4-0.7 mm). When compared to patients with IMT ≤ 0.6 mm, those with IMT > 0.6 mm were older (p = 0.001), had higher prevalence of male (p = 0.001) and had lower eGFR (p = 0.01). These patients also had higher prevalence of coronary calcification (p = 0.001). During the follow-up, there were no differences in the occurrence of cardiovascular events and deaths between the two groups.

Conclusion: IMT in early-stage CKD patients was related to coronary calcification, but not with the occurrence of cardiovascular events or death.