Journal of International Medical Research (Sep 2018)

Chronic kidney disease is associated with carotid atherosclerosis and symptomatic ischaemic stroke

  • Nobuo Kajitani,
  • Haruhito A. Uchida,
  • Isao Suminoe,
  • Yuki Kakio,
  • Masashi Kitagawa,
  • Hajime Sato,
  • Jun Wada

DOI
https://doi.org/10.1177/0300060518781619
Journal volume & issue
Vol. 46

Abstract

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Objective We aimed to investigate the relationships among chronic kidney disease (CKD), symptomatic ischaemic stroke, and carotid atherosclerosis. Methods We enrolled 455 patients who underwent carotid ultrasonography in our hospital, including 311 patients with symptomatic ischaemic stroke and 144 patients without symptomatic ischaemic stroke. Carotid intima–media thickness (IMT), the rate of internal carotid artery stenosis, and maximal plaque size were evaluated. Results The mean age of the patients was 68.5 ± 11.0 years and the mean estimated glomerular filtration rate (eGFR) was 68.8 ± 18.2 mL/min/1.73 m 2 . After adjustment for cardiovascular risk factors, the mean IMT was significantly higher in patients with CKD than in those without CKD. The IMT and eGFR were negatively correlated in patients with stroke (r = −0.169). Multiple logistic regression analyses showed that mean IMT, plaque size, and internal carotid artery stenosis were significant determinants of symptomatic ischaemic stroke after adjustment of multivariate risk factors. Furthermore, the eGFR was a negative determinant of symptomatic ischaemic stroke after adjusting for classical risk factors (odds ratio [95% confidence interval] = 0.868 [0.769–0.979]). Conclusion CKD might be associated with the carotid atherosclerosis and symptomatic ischaemic stroke.