心血管疾患と診断

Subclinical Atherosclerosis in Non-dialysis Chronic Renal Patients

Abstract

Wagner Ramos Borges, Andre Mauricio Souza Fernandes, Andre Rodrigues Duraes, Roque Aras Junior and Joao Lima

Background: Nowadays cardiovascular diseases are the main cause of morbid-mortality. Atherosclerosis is one of the most important in this class of diseases. Aim: Identifying subclinical atherosclerosis in a population of non-dialytic patients with chronic kidney disease. Methods: From November 2012 to December 2013, we selected 40 patients with stage 3 or 4 of CKD (Chronic kidney disease) who did not need hemodialysis. CACS (coronary artery calcium score) and MTCA (miointimal tichness carotid artery) were calculated and their mean and standard deviation, median and quartiles. To verify the association between the variables we used the Fisher exact test and the Spearman correlation (p<0.05). Results: The distribution of the CACS was not as expected and the median increased with age groups. The CACS was null in : 50% of the sample in all patients below 45 years of age, 50% of those between 45-49 years of age and 50-54 years of age, 53.8% in those 55-59 years of age and 25% of those 60-65 years of age, however p value=0.102. The median MTCA was 0.9 mm with interquartile range of 0.7-1.2 mm. In percentil75 for age and sex were : 80% of 45 year olds, 25% of 45-49 year olds, 66.7% of 50-54 year olds, 69.2% of 55-59 year olds and 50% of 60-65 year olds, though p value was 0.602. We found a moderate positive correlation between age and CACS (r=0.458 p=0.03) and between age and MTCA weak (r=0.346 p=0.029) when performed correlation of age with the values of CACS and MTCA. The correlation between MTCA and CACS was strong(r=0.807) p<0.001. Conclusion: Non-invasive tests in CKD non-dialytic patients can identify subclinical atherosclerosis through the CACS and MTCA. This may change the clinical management, evolution and prognosis.