Divergent Occurrence of Carotid Intima-Media Thickness and Carotid Arteries Plaques in Stable Kidney Transplant Recipients

Abstract

Background: Carotid atherosclerosis is one of the main cerebrovascular complications in kidney transplant recipients (KTRs). We analyzed the relationships between carotid intima-media thickness (IMT) and the occurrence and characteristics of carotid plaques in a cohort of KTRs. Methods: In 500 KTRs (aged 49.9 ± 12.0 years), IMT was measured and carotid plaques were semi-qualitatively assessed. Concomitantly, biochemical and hormonal inflammatory, vascular and calcium-phosphate metabolism parameters were also assessed. Results: In 10.2% of patients, a side-to-side IMT difference >0.1 mm was observed, whereas 26.8% of patients with no plaques in one carotid artery had at least one contralateral calcified plaque. Multivariate logistic regression analysis revealed that age (rpartial = 0.409; p < 0.001), male sex (rpartial = 0.199; p < 0.001), and coronary artery disease (rpartial = 0.139; p < 0.01) independently increased IMT (R2 = 0.25). For the occurrence of calcified carotid plaques, age (rpartial = 0.544; p < 0.001), male gender (rpartial = 0.127; p < 0.05), and the duration of renal insufficiency prior to transplantation (rpartial = 0.235; p < 0.001) were confirmed as independent variables. Conclusions: Substantial side-to-side differences in IMT values and carotid plaques distribution are present in a large percentage of stable KTRs. In addition, there are different clinical risk factors profiles associated with IMT and the presence of calcified plaques. Vascular and calcium-phosphate metabolism biomarkers were not associated with any carotid atherosclerosis characteristics.

Keywords

• atherosclerosis
• biomarkers
• calcified plaques
• kidney transplantation
• ultrasound