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Aspects of carotid structure and function in health and different stages of chronic kidney disease
Author(s) -
Asp Anna M.,
Wallquist Carin,
Rickenlund Anette,
Hylander Britta,
Jacobson Stefan H.,
Caidahl Kenneth,
Eriksson Maria J.
Publication year - 2018
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12429
Subject(s) - medicine , kidney disease , arterial stiffness , cardiology , blood pressure , renal function , dialysis , common carotid artery , pulse wave velocity , intima media thickness , carotid arteries
Summary Introduction Arterial remodelling and stiffening have been demonstrated in end‐stage renal disease ( ESRD ). The presence of vascular alterations in earlier‐stage chronic kidney disease ( CKD ) is less studied. We evaluated vascular structure and function in mild‐to‐moderate CKD (stages 2–3) compared with healthy subjects and advanced CKD (stages 4–5). Methods Carotid ultrasound was performed in 103 non‐dialysis CKD patients and 54 healthy controls. Carotid intima‐media thickness ( CIMT ) and common carotid artery ( CCA ) diameter were measured. Strain, stiffness and the pressure‐strain elastic modulus ( E p ) of the right CCA were calculated. Results There was no significant difference in CCA diameter between CKD 2–3 and controls. The CCA diameter was larger in CKD 4–5 compared with CKD 2–3 and controls ( CKD 4–5, 6·50 ± 0·79 mm versus CKD 2–3, 6·08 ± 0·56 mm, P = 0·003; and versus controls 5·97 ± 0·53 mm, P <0·001). However, after adjustments, the difference in CCA diameter was valid only for older ages and also dependent on systolic blood pressure ( SBP ). There were no significant differences in CIMT , strain or stiffness between the groups, but E p was higher in CKD 4–5 compared with controls ( P = 0·006). Conclusion In mild‐to‐moderate CKD , there were no significant differences in carotid artery structure or function compared with healthy subjects. Only patients with advanced CKD and older ages showed signs of arterial remodelling. Our study indicates that vascular alterations occur in advanced CKD , with SBP and age as important contributing factors.