Skip to main content

Advertisement

SpringerLink
Log in

Assessment of the relationship between selected cardiovascular risk factors and the indices of intima-media thickness and coronary artery calcium score in various stages of chronic kidney disease

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Renal diseases pose a growing epidemiological and health problem worldwide. Cardiovascular diseases are the leading cause of deaths among patients with chronic kidney disease. Increased risk of atherosclerosis in these patients results from the occurrence of traditional and non-traditional risk factors. The aim of this study was to assess the relationship between selected risk factors for cardiovascular diseases (age, sex, dyslipidemia, hypertension, etc.), intima-media thickness and coronary artery calcium score in patients with chronic kidney disease stages 2, 3 and 4. This study included 60 patients with chronic kidney disease divided into 3 groups on the basis of disease stage and control group consisting of 20 individuals without diagnosed chronic kidney disease and cardiovascular diseases. Blood analysis and blood pressure measurements were taken. All patients underwent carotid artery ultrasound with the assessment of the intima-media thickness, and heart CT scan in order to assess the index of coronary artery calcification. Logistic regression analysis revealed statistically significant correlation between blood vessels calcification and age—the increase in age by 1 year was associated with the increase in the risk of coronary artery calcification by 6.7 %. The increase in IMT by about 0.1 mm raises the risk of calcification by about 2 %. Second logistic regression model revealed that one-year increase in age was associated with an increase in the risk of intima-media thickening by 6.5 %. Occurrence of hypertension was associated with a ninefold increase in intima-media thickening risk in comparison with patients with normal blood pressure. To sum up, age and hypertension were associated with the growth of IMT in CKD patients, while age and exposure to tobacco smoke were associated with the increase in coronary artery calcium score. The relationship between thickening of IMT and the increase in calcification index in patients was also observed in study group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Król E, Rutkowski B, Czarniak P et al (2009) Early detection of chronic kidney disease: results of the PolNef study. Am J Nephrol 29(3):264–273

    Article  PubMed Central  PubMed  Google Scholar 

  2. Rutkowski B, Czekalski S, Sułowicz W et al (2004) Epidemiology of kidney disease in Poland: pilot program (PolNef). Przegl Lek 61(1):22–24 (in Polish)

    PubMed  Google Scholar 

  3. Król E, Czarniak P, Szcześniak P (2009) What do we know about chronic kidney disease? The results of PolNef 2007 program. Nefrologia i Dializoterapia Polska 13(2):57 (in Polish)

    Google Scholar 

  4. Coresh J, Astor B, Greene T et al (2003) Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 41(1):1–12

    Article  PubMed  Google Scholar 

  5. Atkins R, Polkinghorne K, Briganti E et al (2004) Prevalence of albuminuria in Australia. Kidney Int Suppl(92):S22–S24

    Article  Google Scholar 

  6. Jungers P (1999) Screening for renal insufficiency: is it worth a while? is it feasible? Nephrol Dial Transplant 14(9):2082–2084

    Article  CAS  PubMed  Google Scholar 

  7. Yamagata K, Ishida K, Sairenchi T et al (2007) Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. Kidney Int 71:159–166

    Article  CAS  PubMed  Google Scholar 

  8. Muntner P, He J, Astor BC, Folsom AR, Coresh J (2005) Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol 16(2):529–538

    Article  PubMed  Google Scholar 

  9. Parikh Nisha I, Hwang Shih-Jen, Larson Martin G (2006) Cardiovascular disease risk factors in chronic kidney disease overall burden and rates of treatment and control E. Arch Intern Med 166(17):1884–1891

    Article  PubMed  Google Scholar 

  10. Książek A, Rutkowski B (2004) Nefrology. Czelej, Lublin (in Polish)

  11. Foley RN, Parfrey PS, Sarnak MJ (1998) The clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32(Suppl 3):S112–S119

    Article  CAS  PubMed  Google Scholar 

  12. Steciwko A, Mastalerz-Migas A (2006) Chronic kidney disease and its impact on cardiovascular disease. Terapia 9(1):183 (in Polish)

    Google Scholar 

  13. Jardine AG, McLaughlin K (2001) Cardiovascular complications of renal disease. Heart 86(4):459–466

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Giass CK, Witztum JL (2001) Atherosclerosis: the road ahead. Cell 104:503–516

    Article  Google Scholar 

  15. Shlipak MG, Fried LF, Cushman M et al (2005) Cardiovascular mortality risk in chronic kidney disease comparison of traditional and novel risk factors. JAMA 293(14):1737–1745

    Article  CAS  PubMed  Google Scholar 

  16. KDIGO (2012) Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 3(1). doi:10.1038/kisup.2012.73

  17. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G (2003) National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139(2):137–147

    Article  PubMed  Google Scholar 

  18. Guidelines Committee (2003) European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension. http://www.eshonline.org/education/esh2003/home_guidelines.htm

  19. Pasowicz M (2007) Calcification of coronary arteries: coronary artery calcium score index. In: Podolec P (ed) Polish forum for prevention guidelines, vol 1. Medycyna Praktyczna, Krakow, pp 369–378

    Google Scholar 

  20. Rumberger JA, Brundage BH, Rader DJ et al (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74(3):243–252

    Article  CAS  PubMed  Google Scholar 

  21. Małyszko J, Małyszko J, Mysliwiec M (2009) The cardio-renal anemia syndrome in hemodialysis patients. Przegląd Kardiodiabetologiczny 4(3):138–141 (in Polish)

    Google Scholar 

  22. Król E, Czarniak P, Rutkowski B (2008) Effectiveness of antihypertensive treatment in patients with chronic kidney disease. J Ren Nutr 18(1):134–139

  23. Kośmicki M (2001) Smoking of patients with ischemic heart disease: therapy possibilities. Przew Lek 4:38–47 (in Polish)

    Google Scholar 

  24. Kestenbaum B, Sampson JN, Rudser KD et al (2005) Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol 16:520–528

    Article  CAS  PubMed  Google Scholar 

  25. Okuno S, Ishimura E, Kitatani K et al (2007) Presence of abdominal aortic calcification is significantly associated with all-caused and cardiovascular mortality in maintenance hemodialysis patients. Am J Kidney Dis 49:417–425

    Article  PubMed  Google Scholar 

  26. Formanowicz D (2006) Anemia in end-stage renal failure-from the discovery to the present day. Nowiny Lekarskie 75(6):576–581 (in Polish)

    Google Scholar 

  27. Matsouka M, Iseki K, Tamashiro M et al (2004) Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysis. Clin Exp Nephrol 8(1):54–58

    Article  Google Scholar 

  28. Elias-Smale SE, Proença RV, Koller MT (2010) Coronary calcium score improves classification of coronary heart disease risk in the elderly: the Rotterdam study. J Am Coll Cardiol 56:1407–1414

    Article  PubMed  Google Scholar 

  29. Greenland P, Bonow RO, Brundage BH et al (2007) ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. J Am Coll Cardiol 49:378–402

    Article  PubMed  Google Scholar 

  30. Braun J, Oldendorf M, Moshage W, Heidler R, Zeitler E, Luft FC (1996) Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients. Am J Kidney Dis 27:394–401

    Article  CAS  PubMed  Google Scholar 

  31. Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D et al (2000) Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342:1478–1483

    Article  CAS  PubMed  Google Scholar 

  32. Watanabe R, Lemos M, Manfredi S (2010) Impact of cardiovascular calcification in non-dialyzed patients after 24 months of follow-up. Clin J Am Soc Nephrol 5(2):189–194

    Article  PubMed Central  PubMed  Google Scholar 

  33. Guerin AP, London GM, Marchais SJ, Metivier F (2000) Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 15:1014–1021

    Article  CAS  PubMed  Google Scholar 

  34. Taylor AJ, Feuerstein I, Wong H (2001) Do conventional risk factors predict subclinical coronary artery disease? Results from the prospective army coronary calcium project. Am Heart J 141:463–468

    Article  CAS  PubMed  Google Scholar 

  35. Terry JG, Carr JJ, Tang R et al (2005) Coronary artery calcium outperforms carotid artery intima-media thickness as a noninvasive index of prevalent coronary artery stenosis. Arterioscler Thromb Vasc Biol 25:1723–1728

    Article  CAS  PubMed  Google Scholar 

  36. Ming Ng R, Chua T, Allen J (2012) Correlation between carotid intima media thickness, carotid plaque and Coronary artery calcium score in asymptomatic Asians. J Am Coll Cardiol 59(13s1):E1190–E1190

    Google Scholar 

  37. Sosnowski C, Pasierski T, Janeczko-Sosnowska E et al (2005) The thickness of intima and media of large peripheral arteries. Folia Cardiol 12(5):382–393

    Google Scholar 

  38. Dijk JM, van der Graaf Y, Bots ML, Grobbee DE, Algra A (2006) Carotid intima-media thickness and the risk of new vascular events in patients with manifest atherosclerotic disease: the SMART study. Eur Heart J 27:1971–1978

    Article  PubMed  Google Scholar 

  39. Lorenz MW, Markus HS, Bots ML et al (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115:459–467

    Article  PubMed  Google Scholar 

  40. Rossi M, Cupisti A, Santoro G, Morelli E, Meola M, Barsotti G (2002) Ultrasonic tissue characterization of the carotid artery in chronic renal failure patients. Nephron 91(2):270–275

    Article  PubMed  Google Scholar 

  41. Sikorska D, Schwermer K, Hoppe K (2011) Cross-sectional assessment of the association between stage of chronic kidney disease and the presence of inflammation: malnutrition syndrome and selected indicators of changes in the cardiovascular system. Nowiny Lekarskie 80(3):167–173 (in Polish)

    Google Scholar 

  42. Rubenfire M, Rajagopalan S, Mosca L (2000) Carotid artery vasoreactivity in response to sympathetic stress correlates with coronary disease risk and is independent of wall thickness. J Am Coll Cardiol 7:2192–2197

    Article  Google Scholar 

  43. Rahn K, Barenbrock M, Hausberg M, Kosch M, Suwelack B, Witta J (2002) Vessel wall alterations in patients with renal failure. Hypertens Res 23(1):3–6

    Google Scholar 

  44. Skalska A, Klimek E, Wizner B (2007) Kidney function and thickness of carotid intima-media complex in patients with treated arterial hypertension. Blood Press 16(6):367–374

    Article  CAS  PubMed  Google Scholar 

  45. Homma S, Hirose N, Ishida H et al (2001) Carotid plaque and intima-media thickness assessed by b-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke 2:830–835

    Article  Google Scholar 

  46. Borhani N, Mercuri M, Borhani P, Buckalew V, Cannosa-Terris M, Carr A et al (1996) Final outcome results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS): a randomized trial. JAMA 276:785–791

    Article  CAS  PubMed  Google Scholar 

  47. Cuspidi C, Ambrosioni E, Mancia G, Pessina A, Trimarco B, Zanchetti A (2002) Role of echocardiography and carotid ultrasonography in stratifying risk in patients with essential hypertension: the Assessment of Prognostic Risk Observational Survey. J Hypertens 20(7):1307–1314

    Article  CAS  PubMed  Google Scholar 

  48. Zanchetti A, Bond M, Henning M, Neiss A, Mancia G, Dal Palu C, Hannsson L, Magnani B, Ravinetto R (1998) Risk factors associated with alterations in carotid intima-media thickness in hypertension: baseline data from the European Lacidipine Study on Atherosclerosis. J Hypertens 16:949–961

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgement

Two of authors are (partially) supported by the Healthy Ageing Research Centre project (REGPOT-2012-2013-1, 7FP).

Author information

Authors and Affiliations

  1. Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland

    Anna Szarejko-Paradowska, Anna Gluba-Brzózka & Jacek Rysz

  2. Department of Diagnostics and Radiological and Isotopic Therapy, WAM University Hospital in Lodz, Lodz, Poland

    Robert Pietruszyński

  3. Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland

    Anna Gluba-Brzózka & Jacek Rysz

Authors
  1. Anna Szarejko-Paradowska
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anna Gluba-Brzózka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Pietruszyński
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jacek Rysz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anna Gluba-Brzózka.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Szarejko-Paradowska, A., Gluba-Brzózka, A., Pietruszyński, R. et al. Assessment of the relationship between selected cardiovascular risk factors and the indices of intima-media thickness and coronary artery calcium score in various stages of chronic kidney disease. Int Urol Nephrol 47, 2003–2012 (2015). https://doi.org/10.1007/s11255-015-1132-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-015-1132-8

Keywords

Search

Navigation