Different inflammatory markers, brachial artery flow-mediated dilatation (FMD), and brachial intima-media thickness (bIMT) were measured in 50 patients with chronic kidney disease (CKD) stages 3 to 4 with estimated glomerular filtration rate (eGFR) and 35 age- and gender-matched controls. The bIMT was significantly increased in the patients with CKD compared with controls (0.43 mm [0.42, 0.45] vs 0.34 mm [0.32, 0.36]; P < .001). There was no significant difference in FMD between the study groups (4.7% vs 5.3%; P = .56). There were significant correlations between bIMT and high-sensitive C-reactive protein, vascular cellular adhesion molecule 1, tumor necrosis factor, and interleukin 6 (P < .05). However, eGFR adjusted for age and gender was the best predictor of bIMT. In conclusion, bIMT and inflammatory markers were increased in patients with CKD compared with the controls. Furthermore, significant correlations between bIMT and inflammatory activity in patients with CKD were observed. The eGFR adjusted for age and gender was the best predictor of bIMT.
JungersPMassyZANguyen KhoaT. Incidence and risk factors of atherosclerotic cardiovascular accidents in predialysis chronic renal failure patients: a prospective study. Nephrol Dial Transplant. 1997;12(12):2597–2602.
2.
KasiskeBGuijarroCMassyZWiederkehrMMaJ. Cardiovascular disease after renal transplantation. J Am Soc Nephrol. 1996;7(1):158–165.
3.
RaineAEGMargreiterRBrunnerFP. Report on management of renal-failure in Europe, XXII, 1991. Nephrol Dial Transplant. 1992;7(suppl 2):7–35.
4.
TakagiMWadaHMukaiK. Increased vascular endothelial cell markers in patients with chronic renal failure on maintenance haemodialysis. Blood Coagul Fibrinolysis. 1994;5(5):713–717.
5.
vanGuldenerCLambertJJanssenMDonkerAJMStehouwerCDA. Endothelium-dependent vasodilation and distensibility of large arteries in chronic haemodialysis patients. Nephrol Dial Transplant. 1997;12(suppl 2):14–18.
6.
van GuldenerCJanssenMLambertJ. No change in impaired endothelial function after long-term folic acid therapy of hyperhomocysteinaemia in haemodialysis patients. Nephrol Dial Transplant. 1998;13(1):106–112.
7.
CelermajerDSSorensenKEGoochVM. Noninvasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. 1992;340(8828):1111–1115.
8.
ReddyKGNairRNSheehanHMHodgsonJM. Evidence that selective endothelial dysfunction may occur in the absence of angiographic or ultrasound atherosclerosis in patients with risk-factors for atherosclerosis. J Am Coll Cardiol. 1994;23(4):833–843.
9.
BevcSŠabićSHojsR. Atherosclerosis in hemodialysis patients—the role of microinflammation. Ren Fail. 2008;30(10):1012–1016.
10.
StenvinkelPHeimburgerOPaultreF. Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int. 1999;55(5):1899–1911.
11.
LeveyASEckardtK-UTsukamotoY. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67(6):2089–2100.
12.
KawagishiTNishizawaYKonishiT. High-resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int. 1995;48(3):820–826.
13.
HojsR. Carotid intima-media thickness and plaques in hemodialysis patients. Artif Organs. 2000;24(9):691–695.
14.
SavageTClarkeALGilesMTomsonCRVRaineAEG. Calcified plaque is common in the carotid and femoral arteries of dialysis patients without clinical vascular disease. Nephrol Dial Transplant. 1998;13(8):2004–2012.
15.
CorrettiMCAndersonTJBenjaminEJ. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002;39(2):257–265.
16.
WendelhagILiangQGustavssonTWikstrandJ. A new automated computerized analyzing system simplifies readings and reduces the variability in ultrasound measurement of intima-media thickness. Stroke. 1997;28(11):2195–2200.
17.
SalonenRSeppanenKRauramaaRSalonenJT. Prevalence of carotid atherosclerosis and serum-cholesterol levels in eastern Finland. Arteriosclerosis. 1988;8(6):788–792.
18.
PerssonJFormgrenJIsraelssonBBerglundG.Ultrasound-determined intima-media thickness and atherosclerosis. Direct and indirect validation. Arterioscler Thromb. 1994;14(2):261–264.
19.
CelermajerDSSorensenKEGeorgakopoulosD. Cigarette-smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy-young adults. Circulation. 1993;88(5 pt 1):2149–2155.
20.
O'LearyDHPolakJFKronmalRAManolioTABurkeGLWolfsonSK; Cardiovascular Health Study Collaborative Research Group. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340(1):14–22.
21.
RossiRNuzzoAOriglianiGModenaMG. Prognostic role of flow-mediated dilation and cardiac risk factors in post-menopausal women. J Am Coll Cardiol. 2008;51(10):997–1002.
22.
BrevettiGSilvestroASchianoVChiarielloM. Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: additive value of flow-mediated dilation to ankle-brachial pressure index. Circulation. 2003;108(17):2093–2098.
23.
GokceNKeaneyJFJrHunterLM. Predictive value of noninvasively determined endothelial dysfunction for long-term cardiovascular events inpatients with peripheral vascular disease. J Am Coll Cardiol. 2003;41(10):1769–1775.
24.
TouboulPJHennericiMGMeairsS. Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the advisory board of the 3rd and 4th watching the risk symposium, 13th and 15th European stroke conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis. 2007;23(1):75–80.
25.
LocatelliFMarcelliDConteF. Cardiovascular disease in chronic renal failure: the challenge continues. Nephr Dialysis Transplant. 2000;15(suppl 5):69–80.
26.
StenvinkelPPecoits-FilhoRLindholmB. Coronary artery disease in end-stage renal disease: no longer a simple plumbing problem. J Am Soc Nephrol. 2003;14(7):1927–1939.
27.
StenvinkelPHeimbürgerOJogestrandT. Elevated interleukin-6 predicts progressive carotid artery atherosclerosis in dialysis patients: association with Chlamydia pneumoniae seropositivity. Am J Kidney Dis. 2002;39(2):274–282.
28.
KocakHGumusluSSahinE. Relationship between carotid artery intima-media thickness and brachial artery flow-mediated dilation in peritoneal dialysis patients. Int J Urol Nephrol. 2009;41(2):409–416.
29.
ThambyrajahJLandrayMJMcGlynnFJJonesHJWheelerDCTownendJN. Abnormalities of endothelial function in patients with predialysis renal failure. Heart. 2000;83(2):205–209.
30.
YilmazMIStenvinkelPSonmezA. Vascular health, systemic inflammation and progressive reduction in kidney function; clinical determinants and impact on cardiovascular outcomes. Nephrol Dial Transplant. 2011;26(11):3537–3543.
31.
RohaniMJogestrandTKallnerGJussilaRAgewallS. Morphological changes rather than flow-mediated dilatation in the brachial artery are better indicators of the extent and severity of coronary artery disease. J Hypertens. 2005;23(7):1397–1402.
32.
AndersonTJ. Assessment and treatment of endothelial dysfunction in humans. J Am Coll Cardiol. 1999;34(3):631–638.
33.
AkalinATemizGAkcarNSensoyB. Short term effects of atorvastatin on endothelial functions and oxidized LDL levels in patients with type 2 diabetes. Endocr J. 2008;55(5):861–866.
