Journal of Family Medicine and Primary Care

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 8  |  Issue : 4  |  Page : 1447--1452

Assessment of subclinical atherosclerosis and endothelial dysfunction in chronic kidney disease by measurement of carotid intima media thickness and flow-mediated vasodilatation in North Indian population


Munna Lal Patel1, Rekha Sachan2, Gaurav Prakash Singh1, SC Chaudhary1, KK Gupta1, Virendra Atam1, Anit Parihar3 
1 Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India
3 Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Munna Lal Patel
Department of Medicine, King George Medical University, C-28, Sec-J Aliganj, Lucknow - 226 024, Uttar Pradesh
India

Background: Chronic kidney disease (CKD) predisposes to accelerated atherosclerosis that is measured by carotid artery intima media thickness (CIMT) and brachial artery flow-mediated dilation (FMD). The aim of this study was to assess the noninvasive risk markers of subclinical atherosclerosis and endothelial dysfunction and their correlation with disease severity. Methods and Results: This was a cross-sectional study conducted in 62 patients with CKD: 38 predialysis and 24 on hemodialysis and 50 age- and gender-matched controls. In both the patients and controls, high-sensitivity C-reactive protein (CRP) levels, %FMD, and CIMT were measured. Patients with CKD had increased CRP levels {[5.8 (1.0–6.0)] mg/L vs [1.0 (0.5–2.20)] mg/L; P < 0.001}; %FMD was significantly lower in patients on hemodialysis (5.51%) compared with stage IV (7.62%) and stage III (15.02%) and 17.95% in control subjects (P < 0.001); and CIMT values in hemodialysis patients (0.88 ± 0.06 mm) were significantly higher compared with stage IV (0.67 ± 0.10) and stage III (0.61 ± 0.12) (P < 0.001). Increased CIMT values were seen in patients with CKD (0.82 ± 0.21 mm) than in the healthy controls (0.55 ± 0.16 mm). In patients with CKD, a significant negative correlation was found between CRP levels and FMD responses (r = −0.315; P < 0.001), while a significant positive correlation was found between CRP and CIMT values (r = 0.327; P < 0.001). Compared with predialysis, hemodialysis subjects had significantly lower FMD and higher CRP and IMT values. Conclusion: CKD confers a higher inflammatory status when compared with apparently healthy general population. Abnormal FMD responses and CIMT values are more commonly found in dialysis patients. Our findings suggest that CIMT and FMD can be used as noninvasive markers for early risk assessment and stratification in various stages of CKD.


How to cite this article:
Patel ML, Sachan R, Singh GP, Chaudhary S C, Gupta K K, Atam V, Parihar A. Assessment of subclinical atherosclerosis and endothelial dysfunction in chronic kidney disease by measurement of carotid intima media thickness and flow-mediated vasodilatation in North Indian population.J Family Med Prim Care 2019;8:1447-1452


How to cite this URL:
Patel ML, Sachan R, Singh GP, Chaudhary S C, Gupta K K, Atam V, Parihar A. Assessment of subclinical atherosclerosis and endothelial dysfunction in chronic kidney disease by measurement of carotid intima media thickness and flow-mediated vasodilatation in North Indian population. J Family Med Prim Care [serial online] 2019 [cited 2019 Aug 18 ];8:1447-1452
Available from: http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=4;spage=1447;epage=1452;aulast=Patel;type=0