Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
Por:
Palanca, A, Castelblanco, E, Perpinan, H, Betriu, A, Soldevila, B, Valdivielso, JM, Bermudez, M, Duran, X, Fernandez, E, Puig-Domingo, M, Groop, PH, Alonso, N, Mauricio, D
Publicada:
1 sep 2018
Resumen:
Background and aims: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes. Traditional cardiovascular risk factors fail to fully account for the increase in cardiovascular risk in these patients. This study aims to analyse the prevalence and progression of subclinical atherosclerosis in CKD patients with and without diabetes.
Methods: We included data from CKD patients with and without diabetes free from previous cardiovascular events from the NEFRONA cohort. Patients underwent baseline and 24-month follow-up carotid and femoral ultrasound examinations. Multivariable models were used to assess the contribution of diabetes to the presence and plaque progression.
Results: A total of 419 patients with diabetes and 1129 without diabetes were included. Diabetic patients were older, had higher BMIs, more hypertension and dyslipidaemia. At baseline, the proportion of patients with plaque was higher among diabetic patients (81.4% vs. 64.1%, p < 0.001). Diabetic patients more frequently had more than two vascular territories with plaque (64.4% vs. 48.4%, p < 0.001). Multivariable analysis indicated that plaque at baseline was significantly associated with age, gender, smoking and renal replacement therapy (RRT) in the non-diabetic patients, but only with age and male gender in diabetic patients. Plaque progression was significantly associated with age, number of territories with basal plaque, smoking and RRT in both groups.
Conclusions: Subclinical atherosclerosis is more prevalent, carries a higher plaque burden and is more rapidly progressive in renal patients with diabetes. In these patients, diabetes outweighs other described risk factors associated with the presence of subclinical atherosclerosis. (c) 2018 Elsevier B.V. All rights reserved.
Filiaciones:
Palanca, A:
Hlth Sci Res Inst, Dept Endocrinol & Nutr, Badalona, Spain
Univ Hosp Germans Trias i Pujol, Badalona, Spain
Barcelona Autonomous Univ UAB, Dept Med, Barcelona, Spain
Castelblanco, E:
Hlth Sci Res Inst, Dept Endocrinol & Nutr, Badalona, Spain
Univ Hosp Germans Trias i Pujol, Badalona, Spain
Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Perpinan, H:
Inst Recerca Biomed Lleida, Biostat Unit, Lleida, Spain
Betriu, A:
Inst Recerca Biomed Lleida, Vasc & Renal Translat Res Group, Lleida, Spain
Soldevila, B:
Hlth Sci Res Inst, Dept Endocrinol & Nutr, Badalona, Spain
Univ Hosp Germans Trias i Pujol, Badalona, Spain
Barcelona Autonomous Univ UAB, Dept Med, Barcelona, Spain
Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Valdivielso, JM:
Inst Recerca Biomed Lleida, Vasc & Renal Translat Res Group, Lleida, Spain
Bermudez, M:
Inst Recerca Biomed Lleida, Vasc & Renal Translat Res Group, Lleida, Spain
Duran, X:
Inst Hosp Mar Invest Med, Methodol & Biostat Advisory Serv, Barcelona, Spain
Fernandez, E:
Inst Recerca Biomed Lleida, Vasc & Renal Translat Res Group, Lleida, Spain
Puig-Domingo, M:
Hlth Sci Res Inst, Dept Endocrinol & Nutr, Badalona, Spain
Univ Hosp Germans Trias i Pujol, Badalona, Spain
Barcelona Autonomous Univ UAB, Dept Med, Barcelona, Spain
Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Groop, PH:
Folkhalsan Res Ctr, Folkhalsan Inst Genet, Helsinki, Finland
Univ Helsinki, Abdominal Ctr Nephrol, Helsinki, Finland
Univ Helsinki, Cent Hosp, Helsinki, Finland
Univ Helsinki, Res Programs Unit, Diabet & Obes, Helsinki, Finland
Baker IDI Heart & Diabet Inst, Melbourne, Vic, Australia
Alonso, N:
Hlth Sci Res Inst, Dept Endocrinol & Nutr, Badalona, Spain
Univ Hosp Germans Trias i Pujol, Badalona, Spain
Barcelona Autonomous Univ UAB, Dept Med, Barcelona, Spain
Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Mauricio, D:
Barcelona Autonomous Univ UAB, Dept Med, Barcelona, Spain
Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Univ Hosp Santa Creu & St Pau, Dept Endocrinol & Nutr, Carrer St Quinti 89, Barcelona, Spain
IIB St Pau, Barcelona, Spain
Green Published
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