Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes

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Palanca , A , Castelblanco , E , Perpinan , H , Betriu , A , Soldevila , B , Manuel Valdivielso , J , Bermudez , M , Duran , X , Fernandez , E , Puig-Domingo , M , Groop , P-H , Alonso , N & Mauricio , D 2018 , ' Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes ' , Atherosclerosis , vol. 276 , pp. 50-57 . https://doi.org/10.1016/j.atherosclerosis.2018.07.018

Title: Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
Author: Palanca, Ana; Castelblanco, Esmeralda; Perpinan, Hector; Betriu, Angels; Soldevila, Berta; Manuel Valdivielso, Jose; Bermudez, Marcelino; Duran, Xavier; Fernandez, Elvira; Puig-Domingo, Manel; Groop, Per-Henrik; Alonso, Nuria; Mauricio, Didac
Contributor: University of Helsinki, Doctoral Programme in Clinical Research
Date: 2018-09
Language: eng
Number of pages: 8
Belongs to series: Atherosclerosis
ISSN: 0021-9150
URI: http://hdl.handle.net/10138/305122
Abstract: 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.
Subject: Chronic kidney disease
Diabetes
Subclinical atherosclerosis
Cardiovascular outcomes
INTIMA-MEDIA THICKNESS
PREDICTS CARDIOVASCULAR EVENTS
ALL-CAUSE MORTALITY
CAROTID PLAQUE
RISK-FACTORS
PROSPECTIVE COHORT
DIALYSIS PATIENTS
VASCULAR-DISEASE
FOLLOW-UP
CORONARY
3121 Internal medicine
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