Differential Associations of Traditional and Non-Traditional Risk Factors with Carotid Intima-Media Thickening and Plaque in Peritoneal Dialysis Patients

Abstract

Background: This study sought to examine the associations of traditional and non-traditional cardiovascular risk factors with carotid intima-media thickening and plaque in peritoneal dialysis (PD) patients. Methods: A cross-sectional study was performed in 147 PD patients with carotid intima-media thickness (IMT) and plaque assessed by B-mode ultrasonography and fasting blood collected for biochemical measurements. Results: On univariate analysis, age, smoking history, fibrinogen, C-reactive protein (CRP), adiponectin, fetuin-A, lipoprotein(a) and diastolic blood pressure were associated with carotid IMT while age, smoking history, diabetes, CRP and diastolic blood pressure were associated with carotid plaque. Using multivariate analysis, elevated CRP (p = 0.015) and serum calcium (p = 0.022) were associated with carotid plaque but not with IMT. CRP and serum calcium were synergistically associated with carotid plaque in that those with CRP > median and serum calcium > median showed the highest prevalence of carotid plaque than either factor alone (p = 0.003). Conclusions: An elevated CRP appeared to be a better biomarker of presence of carotid plaque than intima-media thickening. Furthermore, CRP and serum calcium showed synergistic association with presence of carotid plaque. However, our study was limited by the cross-sectional design and baseline laboratory abnormalities were inevitably confounded by the treatment already given, resulting in difficulty to distinguish cause and effect relationship. Nevertheless, these observations warrant further investigation as it may potentially have important implications on differentiating therapeutic strategies for reducing carotid IMT and plaque progression in PD patients.

Journal

Journal ID (publisher-id): AJN

Journal ID (nlm-ta): Am J Nephrol

Journal ID (doi): 10.1159/issn.0250-8095

Title: American Journal of Nephrology

Publisher: S. Karger AG

ISSN (Print): 0250-8095

ISSN (Electronic): 1421-9670

Publication date Subscription-year: 2007

Publication date (Print): September 2007

Publication date (Electronic): 26 July 2007

Volume: 27

Issue: 5

Pages: 458-465

Affiliations

Departments of ^aMedicine and Therapeutics, ^bDiagnostic and Interventional Radiology, and ^cChemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR, China

Article

Publisher ID: 106457 Other ID: Am J Nephrol 2007;27:458–465

DOI: 10.1159/000106457

PubMed ID: 17664864

Copyright statement: © 2007 S. Karger AG, Basel

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Page count

Figures: 1, Tables: 4, References: 35, Pages: 8

Product

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Categories

Subject: Original Report: Patient-Oriented, Translational Research