Divergent Occurrence of Carotid Intima-Media Thickness and Carotid Arteries Plaques in Stable Kidney Transplant Recipients

Overview

Journal Rev Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2024 Jul 30

PMID 39076672

Authors

Aureliusz Kolonko

Rafal Ficek

Beata Styrc

Michal Sobolewski

Roksana Stankowska

Jerzy Chudek

Andrzej Wiecek

Affiliations

Soon will be listed here.

Abstract

Background: Carotid atherosclerosis is one of the main cerebrovascular complications in kidney transplant recipients (KTRs). We analyzed the relationships between carotid intima-media thickness (IMT) and the occurrence and characteristics of carotid plaques in a cohort of KTRs.

Methods: In 500 KTRs (aged 49.9 12.0 years), IMT was measured and carotid plaques were semi-qualitatively assessed. Concomitantly, biochemical and hormonal inflammatory, vascular and calcium-phosphate metabolism parameters were also assessed.

Results: In 10.2% of patients, a side-to-side IMT difference 0.1 mm was observed, whereas 26.8% of patients with no plaques in one carotid artery had at least one contralateral calcified plaque. Multivariate logistic regression analysis revealed that age ( = 0.409; 0.001), male sex ( = 0.199; 0.001), and coronary artery disease ( = 0.139; 0.01) independently increased IMT ( = 0.25). For the occurrence of calcified carotid plaques, age ( = 0.544; 0.001), male gender ( = 0.127; 0.05), and the duration of renal insufficiency prior to transplantation ( = 0.235; 0.001) were confirmed as independent variables.

Conclusions: Substantial side-to-side differences in IMT values and carotid plaques distribution are present in a large percentage of stable KTRs. In addition, there are different clinical risk factors profiles associated with IMT and the presence of calcified plaques. Vascular and calcium-phosphate metabolism biomarkers were not associated with any carotid atherosclerosis characteristics.

References

Kurnatowska I, Grzelak P, Stefanczyk L, Nowicki M . Tight relations between coronary calcification and atherosclerotic lesions in the carotid artery in chronic dialysis patients. Nephrology (Carlton). 2010; 15(2):184-9. DOI: 10.1111/j.1440-1797.2009.01169.x. View

Yerram P, Karuparthi P, Hesemann L, Horst J, Whaley-Connell A . Chronic kidney disease and cardiovascular risk. J Am Soc Hypertens. 2010; 1(3):178-84. DOI: 10.1016/j.jash.2007.01.010. View

Molinari F, Meiburger K, Saba L, Rajendra Acharya U, Ledda G, Zeng G . Ultrasound IMT measurement on a multi-ethnic and multi-institutional database: our review and experience using four fully automated and one semi-automated methods. Comput Methods Programs Biomed. 2012; 108(3):946-60. DOI: 10.1016/j.cmpb.2012.05.008. View

Savage T, Clarke A, Giles M, Tomson C, Raine A . Calcified plaque is common in the carotid and femoral arteries of dialysis patients without clinical vascular disease. Nephrol Dial Transplant. 1998; 13(8):2004-12. DOI: 10.1093/ndt/13.8.2004. View

Suwelack B, Witta J, Hausberg M, Muller S, Rahn K, Barenbrock M . Studies on structural changes of the carotid arteries and the heart in asymptomatic renal transplant recipients. Nephrol Dial Transplant. 1999; 14(1):160-5. DOI: 10.1093/ndt/14.1.160. View

. 2. Classification and Diagnosis of Diabetes: . Diabetes Care. 2018; 42(Suppl 1):S13-S28. DOI: 10.2337/dc19-S002. View

Howard G, Burke G, Evans G, Crouse 3rd J, Riley W, Arnett D . Relations of intimal-medial thickness among sites within the carotid artery as evaluated by B-mode ultrasound. ARIC Investigators. Atherosclerosis Risk in Communities. Stroke. 1994; 25(8):1581-7. DOI: 10.1161/01.str.25.8.1581. View

Held C, Hjemdahl P, Eriksson S, Bjorkander I, Forslund L, Rehnqvist N . Prognostic implications of intima-media thickness and plaques in the carotid and femoral arteries in patients with stable angina pectoris. Eur Heart J. 2001; 22(1):62-72. DOI: 10.1053/euhj.1999.2006. View

Demuth K, Blacher J, Guerin A, Benoit M, Moatti N, Safar M . Endothelin and cardiovascular remodelling in end-stage renal disease. Nephrol Dial Transplant. 1998; 13(2):375-83. DOI: 10.1093/oxfordjournals.ndt.a027833. View

10.

Spence J . Technology Insight: ultrasound measurement of carotid plaque--patient management, genetic research, and therapy evaluation. Nat Clin Pract Neurol. 2006; 2(11):611-9. DOI: 10.1038/ncpneuro0324. View

11.

Prabhakaran S, Singh R, Zhou X, Ramas R, Sacco R, Rundek T . Presence of calcified carotid plaque predicts vascular events: the Northern Manhattan Study. Atherosclerosis. 2007; 195(1):e197-201. PMC: 6286814. DOI: 10.1016/j.atherosclerosis.2007.03.044. View

12.

Bossuyt J, Van Bortel L, de Backer T, Van de Velde S, Azermai M, Segers P . Asymmetry in prevalence of femoral but not carotid atherosclerosis. J Hypertens. 2014; 32(7):1429-34. DOI: 10.1097/HJH.0000000000000205. View

13.

Malik J, Kudlicka J, Tuka V, Chytilova E, Adamec J, Rocinova K . Common carotid wall shear stress and carotid atherosclerosis in end-stage renal disease patients. Physiol Res. 2012; 61(4):355-61. DOI: 10.33549/physiolres.932259. View

14.

Benedetto F, Tripepi G, Mallamaci F, Zoccali C . Rate of atherosclerotic plaque formation predicts cardiovascular events in ESRD. J Am Soc Nephrol. 2008; 19(4):757-63. PMC: 2390959. DOI: 10.1681/ASN.2007070813. View

15.

Kajitani N, Uchida H, Suminoe I, Kakio Y, Kitagawa M, Sato H . Chronic kidney disease is associated with carotid atherosclerosis and symptomatic ischaemic stroke. J Int Med Res. 2018; 46(9):3873-3883. PMC: 6136003. DOI: 10.1177/0300060518781619. View

16.

Batko K, Krzanowski M, Pietrzycka A, Gajda M, Dumnicka P, Fedak D . Interplay of nitric oxide metabolites and markers of endothelial injury, inflammation, and vascular disease in the spectrum of advanced chronic kidney disease. Kardiol Pol. 2019; 78(1):51-58. DOI: 10.33963/KP.15065. View

17.

Soares Torres F, Fuchs S, Maestri M, Fuchs F, Oliveira M, Moreira L . Association between carotid intima-media thickness and retinal arteriolar and venular diameter in patients with hypertension: a cross-sectional study. Atherosclerosis. 2013; 229(1):134-8. DOI: 10.1016/j.atherosclerosis.2013.04.019. View

18.

Adeney K, Siscovick D, Ix J, Seliger S, Shlipak M, Jenny N . Association of serum phosphate with vascular and valvular calcification in moderate CKD. J Am Soc Nephrol. 2008; 20(2):381-7. PMC: 2637048. DOI: 10.1681/ASN.2008040349. View

19.

Stoumpos S, Jardine A, Mark P . Cardiovascular morbidity and mortality after kidney transplantation. Transpl Int. 2014; 28(1):10-21. DOI: 10.1111/tri.12413. View

20.

Naqvi T, Lee M . Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging. 2014; 7(10):1025-38. DOI: 10.1016/j.jcmg.2013.11.014. View