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

2018 ◽  
Vol 46 (9) ◽  
pp. 3873-3883 ◽  
Author(s):  
Nobuo Kajitani ◽  
Haruhito A. Uchida ◽  
Isao Suminoe ◽  
Yuki Kakio ◽  
Masashi Kitagawa ◽  
...  

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 m2. 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.

2020 ◽  
Vol 5 (3) ◽  
pp. 271-277
Author(s):  
Melina GHE den Brok ◽  
Laurien S Kuhrij ◽  
Bob Roozenbeek ◽  
Aad van der Lugt ◽  
Pieter HE Hilkens ◽  
...  

Introduction Literature on prevalence of symptomatic internal carotid artery stenosis is scarce and heterogeneous. Prevalence may have decreased in recent years due to improved management of cardiovascular risk factors. We aim to estimate current prevalence and identify risk factors of ipsilateral internal carotid artery stenosis in patients with recent hemispheric transient ischaemic attack or ischaemic stroke in the Netherlands. Patients and methods We included consecutive adult patients admitted to two large hospitals in the Netherlands in 2014 who suffered from amaurosis fugax, retinal ischaemia, transient ischaemic attack or ischaemic stroke in the vessel territory of the internal carotid artery. Primary outcome was presence of ipsilateral internal carotid artery stenosis (degree subdivided following NASCET criteria), as assessed with duplex ultrasonography, computed tomography angiography and/or magnetic resonance angiography. We used univariable and multivariable logistic regression to identify risk factors for the presence of a 50–100% internal carotid artery stenosis. Results We analysed 883 consecutive patients with recent transient ischaemic attack or ischaemic stroke. Of these, 110 (12.5%) had 50–99% ipsilateral internal carotid artery stenosis. Subgroup analyses showed higher prevalence of any degree of internal carotid artery stenosis for male sex and White patients. In adjusted analyses, higher age (odds ratio 1.4/10 years; 95% confidence interval 1.16–1.63), male sex (odds ratio 2.8; 95% confidence interval 1.83–4.19), retinal ischaemia (odds ratio 2.5; 95% confidence interval 1.32–4.76) and current smoking (odds ratio 1.8; 95% confidence interval 1.09–2.79) were statistically significant risk factors for 50–100% internal carotid artery stenosis. Conclusion The prevalence of internal carotid artery stenosis seems to be lower in patients with recent transient ischaemic attack or ischaemic stroke than stated in previous studies. We found that higher age, male sex, White ethnicity, retinal ischaemia and current smoking were important risk factors for symptomatic internal carotid artery stenosis.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tae Jung Kim ◽  
Jun Yup Kim ◽  
Chi Kyung Kim ◽  
Yerim Kim ◽  
Seunguk Jung ◽  
...  

Background: Chronic kidney disease (CKD) increases risk of cardiovascular diseases, which might be mediated by facilitation of atherosclerosis. However, impact of CKD on progression of atherosclerosis has not been fully evaluated, and we sought to investigate associations between CKD and extent of carotid atherosclerosis. Methods: Between January 2009 and February 2013, we enrolled a consecutive series of 147 CKD patients and compared the same number of age, sex and vascular risk factor-matched 147 control subjects who visited our hospital during the same period. Carotid atherosclerosis was examined with MR angiography of internal carotid artery (ICA). The degree of stenosis of the internal carotid artery (ICA) in each patient was classified into 5 grades; (1) normal; (2) mild (<50%); (3) moderate (50-69%) ;(4) severe (70-99%); (5) occlusion. Results: Mean age of the subjects was 72.2±8.7 years, and 208 were male (70.7%) among the total of 294 subjects. Significant stenosis of ICA (stenosis more than 50%) was more prevalent in CKD patients [odds ratio (OR) 6.7; 95% confidence interval (CI) 2.2-20.4, p=0.001). The presence of CKD was an independently risk factor for increasing the severity of stenosis of ICA (mild, OR 4.5, 95% CI 2.0-10.2; moderate, OR 3.9, 95% CI 1.3-22.4; severe, OR 12.0, 95% CI 4.3-34.6; occlusion, 14.1, 95% CI 2.1-92.2). Conclusion: In the current case-control study, we found that CKD is associated with incidence of significant carotid stenosis and increases the severity of carotid stenosis. Our results indicate that CKD should be treated as a new risk factor for carotid atherosclerosis.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared


Author(s):  
Ashwini Shenai ◽  
Savitha G

Objective: Metabolic syndrome (MetS) is a common health problem worldwide. According to third national health and nutrition examination survey criteria, about 47 million people have MetS. It is defined as having three or more of the following five risk factors including abdominal obesity, increased triglyceride levels, low-density lipoprotein cholesterol level, elevated blood pressure, and elevated fasting glucose levels. These components of MetS are major risk factors for the development of chronic kidney disease (CKD) also. CKD is a major public problem and it is a major risk factor for the development of cardiovascular disease. Hence, the aim of the current study was to evaluate the association between MetS and CKD.Methods: A total of 50 patients reporting to Saveetha Dental College and Hospitals were enrolled into the study which includes 25 patients with MetS and 25 healthy individuals. 5 mL of venous blood was collected and centrifuged. Then, it is analyzed for fasting blood sugar (FBS), serum triglycerides, serum urea, and creatinine using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software.Results: The mean body mass index, FBS, serum creatinine, and triglyceride levels were higher in MetS patients in comparison to healthy individuals. The mean body mass index (BMI), FBS, serum urea, serum creatinine, and triglyceride levels in the control group and MetS group were 27.75±3.67, 84.8±12.5, 17.52±5.2, 0.91±0.17, and 96.5±60.13 and 35.14±4.25, 108.8±34.69, 21.4±5.9, 1.0±0.14, and 239.76±51.21, respectively. There was a significant difference in the mean BMI, FBS, urea, creatinine, and triglyceride levels of the above group.Conclusion: Serum urea and creatinine levels were significantly higher in MetS individuals. Hence, MetS could be a one of the risk factors for the development of CKD.


2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Worapot Rojsanga ◽  
Kittisak Sawanyawisuth ◽  
Verajit Chotmongkol ◽  
Somsak Tiamkao ◽  
Kannikar Kongbonkiat ◽  
...  

Large cerebral infarctions have high morbidity and mortality. Patients with large cerebral infarctions may have recurrent ischemia as high as 8.1% within 7 days; highest among other types of strokes. Data regarding risk factors for large cerebral infarction in Asian populations are still scant. All adult (age ≥15 years old) patients with the diagnosis of thrombotic ischemic stroke who were treated at Srinagarind Hospital, Khon Kaen University, Thailand from January 2012 to December 2013 were studied. Large cerebral infarctions are defined by clinical criteria of having cerebral cortical impairment, brain stem or cerebellar dysfunction with infarction sizes of more than 1.5 cm. The association of various stroke risk factors and large infarction strokes were calculated using multiple logistic regression analysis. There were 276 thrombotic stroke patients who met the study criteria; classified as large cerebral infarctions in 59 patients (21.38%) and small cerebral infarctions in 217 patients (78.62%). Baseline characteristics and risk factors for stroke were comparable between both groups. The large cerebral infarction group had a significantly larger proportions of right internal carotid artery stenosis, plaques on the left side, left internal carotid artery stenosis, and internal carotid artery stenosis at any side than the small cerebral infarction group. Among various stroke risk factors, only internal carotid artery stenosis at any side was the only significant factor associated with large cerebral infarction with an adjusted odds ratio of 11.14 (95% CI: 3.46, 35.82). In conclusion, significant internal carotid artery stenosis is associated with large cerebral infarction.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Betül İlkay Sezgin Akçay ◽  
Esra Kardeş ◽  
Sultan Maçin ◽  
Cihan Ünlü ◽  
Engin Bilge Özgürhan ◽  
...  

Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population.Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique.Results. The mean age of the patients was71.9±10.8years. The mean percentage of ICA stenosis was74±4.9% in Group 1 and47.5±7.7% in Group 2. The mean SFCT was231.9±44.6 μm in Group 1 and216.2±46.8 μm in Group 2, which was significantly lower (P=0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r=0896,P=0.001).Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%.


Author(s):  
R Chandan Bala ◽  
M Jayabharathy ◽  
S Sheba Yesu Priya ◽  
S Ramya

Introduction: Chronic kidney failure in India and around the world is a significant health problem. The most effective and affordable treatment may require screening for early detection,intervention and prevention. Public awareness is a key determinant to overcome the burden of Chronic Kidney Disease(CKD). However, there is a lack of information on CKD among South Indian people. Aim: To assess the awareness and knowledge of CKD among the South Indian population. Materials and Methods: A questionnaire-based cross-sectional study was conducted through an online form; the questions were generally based on the physiological role of kidney and awareness questions related to CKD. The sample size was 500 participants, of age >18 years and snowball sampling method was implemented. Among the study population, 68 participants had a family history of CKD and they were excluded. The data were analysed through Pearson Chi-Square test. Results: The mean knowledge score was 13 (SD±5.0), with values ranging from 0 to 22. The mean age of the population was 47.80±8.5 years. Multiple regression on demographic data and knowledge yielded statistically negligible results.The study population included 432 participants and the result showed the realms that most responded incorrectly were physiology of kidney, CKD symptoms, risk factors and the domain of testing and diagnosis. Conclusion: The participants had ample knowledge of the risk factors, signs and symptoms of CKD and insufficient knowledge of the physiological function of the kidney and the diagnosis of CKD. Therefore, efforts are necessary to create awareness and educate people about the early detection and prevention of CKD.


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