Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
MetadataShow full item record
Background and objectives Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD. Design, setting, participants, & measurements Our multicenter, prospective, observational study included 1553 patients with CKD (2009-2011). Carotid and femoral ultrasounds were performed at baseline and after 24 months. A subgroup of 476 patients with CKD was also randomized to undergo ultrasound examination at 12 months. Progression of atheromatosis was defined as an increase in the number of plaque territories analyzed by multivariate logistic regression. Results Prevalence of atheromatosis was 68.7% and progressed in 59.8% of patients after 24 months. CKD progression was associated with atheromatosis progression, suggesting a close association between pathologies. Variables significantly predicting atheromatosis progression, independent from CKD stages, were diabetes and two interactions of age with ferritin and plaque at baseline. Given that multiple interactions were found between CKD stage and age, phosphate, smoking, dyslipidemia, body mass index, systolic BP (SBP), carotid intima-n-iedia thickness, plaque at baseline, uric acid, cholesterol, 25-hydroxy vitamin D (250H vitamin D), and antiplatelet and phosphate binders use, the analysis was stratified by CKD stages. In stage 3, two interactions (age with phosphate and plaque at baseline) were found, and smoking, diabetes, SBP, low levels of 25OH vitamin D, and no treatment with phosphate binders were positively associated with atheromatosis progression. In stages 4 and 5, three interactions (age with ferritin and plaque and plaque with smoking) were found, and SBP was positively associated with atheromatosis progression. In dialysis, an interaction between body mass index and 25OH vitamin D was found, and age, dyslipidemia, carotid intima-media thickness, low cholesterol, ferritin, and uric acid were positively associated with atheromatosis progression. Conclusions Atheromatosis progression affects more than one half of patients with CKD, and predictive factors differ depending on CKD stage.
Is part ofClinical Journal of The American Society of Nephrology, 2016, vol. 11, num. 2, p. 287-296
European research projects
Showing items related by title, author, creator and subject.
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 Arroyo, David; Betriu i Bars, M. Àngels; Martínez Alonso, Montserrat; Vidal Amat, Teresa; Valdivielso Revilla, José Manuel; Fernández i Giráldez, Elvira (BioMed Central, 2014)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 ...
Factors predicting cardiovascular events in chronic kidney disease patients. Role of subclinical atheromatosis extent assessed by vascular ultrasound Valdivielso Revilla, José Manuel; Betriu i Bars, M. Àngels; Martínez Alonso, Montserrat; Arroyo, David; Bermúdez López, Marcelino; Fernández i Giráldez, Elvira (Public Library of Science, 2017)Patients with chronic kidney disease (CKD) have an increased incidence of cardiovascular events (CVE). The contribution of subclinical atheromatosis extent, including femoral arteries, to CVE in CKD patients has not been ...
Mineral metabolism factors predict accelerated progression of common carotid intima-media thickness in chronic kidney disease: the NEFRONA study Abajo, María; Betriu i Bars, M. Àngels; Arroyo, David; Gracia, Marta; Pino, María Dolores del; Martínez, Isabel; Valdivielso Revilla, José Manuel; Fernández i Giráldez, Elvira (Oxford University Press, 2017-08-27)BACK GROUND: The leading cause of premature death in chronic kidney disease (CKD) is cardiovascular disease (CVD), but risk assessment in renal patients is challenging. The aim of the study was to analyse the factors that ...