Observational multicenter study to evaluate the prevalence and prognosis of subclinical atheromatosis in a Spanish chronic kidney disease cohort: baseline data from the NEFRONA study

View/ Open
Issue date
2014Author
Arroyo, David
Vidal Amat, Teresa
Suggested citation
Arroyo, David;
Betriu i Bars, M. Àngels;
Martínez Alonso, Montserrat;
Vidal Amat, Teresa;
Valdivielso Revilla, José Manuel;
Fernández i Giráldez, Elvira;
.
(2014)
.
Observational multicenter study to evaluate the prevalence and prognosis of subclinical atheromatosis in a Spanish chronic kidney disease cohort: baseline data from the NEFRONA study.
BioMed Central Nephrology 2014, vol. 15, núm. 168, p. 1-10.
https://doi.org/10.1186/1471-2369-15-168.
Metadata
Show full item recordAbstract
Background: Cardiovascular events (CVE) are more prevalent in chronic kidney disease (CKD) than in general
population, being the main cause of morbimortality. Specific risk factors related to CKD have been suggested,
because traditional factors do not fully explain this increase in cardiovascular disease rates. However, the role of
atheromatosis, its pathogenesis and evolution are still unclear. The potential use of diagnostic tests to detect
subclinical atheromatosis has to be determined.
Methods: NEFRONA is a prospective multicenter cohort study. 2445 CKD subjects were enrolled from 81 Spanish
hospitals and dialysis clinics, from 2010 to 2012. Eligibility criteria included: 18 to 74 years old, CKD stage 3 or
higher, and no previous CVE. 559 non-CKD controls were also recruited. Demographical, clinical and analytical data
were collected. Carotid and femoral ultrasounds were performed by a single trained team to measure carotid
intima-media thickness (cIMT) and detect atheromatous plaques. Ankle-brachial index (ABI) was measured.
Results: Differences in age, sex and prevalence and control of cardiovascular risk factors were found between
controls and CKD patients. These differences are similar to those described in epidemiological studies.
No difference was found regarding cIMT between controls and CKD (when subjects with plaques in common carotid
arteries were omitted); earlier CKD stages had higher values. CKD patients had a higher rate of atheromatous plaques,
with no difference between stages in the unadjusted analysis. A group of patients had plaques in femoral arteries but
were plaque-free in carotid arteries, and would have gone underdiagnosed without the femoral study. The percentage
of pathologic ABI was higher in CKD, with higher prevalence in more advanced stages, and a higher rate of ABI >1.4
than <0.9, suggesting more vascular calcification.
Conclusions: NEFRONA is the first large study describing the actual prevalence of subclinical atheromatosis across
different CKD stages. There is a very high rate of atheromatous plaques and pathologic ABI in CKD. Prospective
data will add important information to the pathogenesis and evolution of atheromatosis in CKD, compared to
non-CKD subjects.
Is part of
BioMed Central Nephrology 2014, vol. 15, núm. 168, p. 1-10European research projects
Collections
The following license files are associated with this item: