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Título:
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Mineral metabolism factors predict accelerated progression of common carotid intima-media thickness in chronic kidney disease: the NEFRONA study;
Predictors of IMT progression in CKD
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Autor/a:
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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
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Notas:
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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 predict accelerated progression of common carotid intima-media thickness (CCIMT) in a CKD cohort after 2 years of follow-up (2010-12). METHODS: The study included 1152 patients from the NEFRONA cohort with CKD stages 3-5D and without a clinical history of CVD. CCIMT was measured at the far wall on both common carotids. CCIMT progression was defined as the change between CCIMT at baseline and at 24 months for each side, averaged and normalized as change per year. Accelerated progressors were defined as those with a CCIMT change ≥75th percentile. RESULTS: The median CCIMT progression rate was 0.0125 mm/year, without significant differences between CKD stages. The cut-off value for defining accelerated progression was 0.0425 mm/year. After adjustment, age was a common factor among all CKD stages. Traditional cardiovascular risk factors, such as diabetes and systolic blood pressure, were predictors of progression in CKD stages 4-5, whereas high-density lipoprotein and low-density lipoprotein cholesterol predicted progression in women in stage 3. Mineral metabolism factors predicting accelerated progression were serum phosphorus in stages 3 and 5D; low 25-hydroxyvitamin D and parathyroid hormone levels >110 pg/mL in stages 4-5 and intact parathyroid hormone levels out of the recommended range in stage 5D. CONCLUSIONS: Mineral metabolism parameters might predict accelerated CCIMT progression from early CKD stages.
The work presented here was funded
by a research grant from AbbVie and the Spanish government RETIC (RD12/0021) and FIS PS10/00946. |
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Materia(s):
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-Atheromatosis progression
-Intima-media thickness
-Parathyroid hormone
-Phosphorus
-Vitamin D |
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Derechos:
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(c) Oxford University Press, 2016
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Tipo de documento:
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Artículo
Artículo - Versión aceptada |
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Editor:
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Oxford University Press
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