Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD

Background and objectives Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD. Design, setti...

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Autores: Gracia, Marta, Betriu i Bars, M. Àngels, Martínez Alonso, Montserrat, Arroyo, David, Abajo, María, Fernández i Giráldez, Elvira, Valdivielso Revilla, José Manuel
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2016
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10459.1/63139
Acceso en línea:https://doi.org/10.2215/CJN.01240215
http://hdl.handle.net/10459.1/63139
Access Level:acceso abierto
Palabra clave:Atherosclerosis
Chronic kidney disease
Cardiovascular disease
Vitamin D deficiency
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spelling Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKDPredictors of subclinical atheromatosis progression in patients at diferent stages of chronic kidney disease after two years of follow-up. The Nefrona studyGracia, MartaBetriu i Bars, M. ÀngelsMartínez Alonso, MontserratArroyo, DavidAbajo, MaríaFernández i Giráldez, ElviraValdivielso Revilla, José ManuelAtherosclerosisChronic kidney diseaseCardiovascular diseaseVitamin D deficiencyBackground and objectives Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD. Design, setting, participants, & measurements Our multicenter, prospective, observational study included 1553 patients with CKD (2009-2011). Carotid and femoral ultrasounds were performed at baseline and after 24 months. A subgroup of 476 patients with CKD was also randomized to undergo ultrasound examination at 12 months. Progression of atheromatosis was defined as an increase in the number of plaque territories analyzed by multivariate logistic regression. Results Prevalence of atheromatosis was 68.7% and progressed in 59.8% of patients after 24 months. CKD progression was associated with atheromatosis progression, suggesting a close association between pathologies. Variables significantly predicting atheromatosis progression, independent from CKD stages, were diabetes and two interactions of age with ferritin and plaque at baseline. Given that multiple interactions were found between CKD stage and age, phosphate, smoking, dyslipidemia, body mass index, systolic BP (SBP), carotid intima-n-iedia thickness, plaque at baseline, uric acid, cholesterol, 25-hydroxy vitamin D (250H vitamin D), and antiplatelet and phosphate binders use, the analysis was stratified by CKD stages. In stage 3, two interactions (age with phosphate and plaque at baseline) were found, and smoking, diabetes, SBP, low levels of 25OH vitamin D, and no treatment with phosphate binders were positively associated with atheromatosis progression. In stages 4 and 5, three interactions (age with ferritin and plaque and plaque with smoking) were found, and SBP was positively associated with atheromatosis progression. In dialysis, an interaction between body mass index and 25OH vitamin D was found, and age, dyslipidemia, carotid intima-media thickness, low cholesterol, ferritin, and uric acid were positively associated with atheromatosis progression. Conclusions Atheromatosis progression affects more than one half of patients with CKD, and predictive factors differ depending on CKD stage.The work presented here was funded by a research grant from Abbvie,the Spanish Government, and Fondos Europeos de Desarrollo, European Funds for Regional Development (FEDER) funds Thematic Networks for Collaborative Research (RETIC) grant RD12/0021/0026 and Fund for Sanitary Research (FIS) grant PS10/00946American Society of Nephrology2018201820162018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://doi.org/10.2215/CJN.01240215http://hdl.handle.net/10459.1/63139http://hdl.handle.net/10459.1/63139reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.2215/CJN.01240215Clinical Journal of The American Society of Nephrology, 2016, vol. 11, num. 2, p. 287-296(c) American Society of Nephrology, 2016info:eu-repo/semantics/openAccessoai:recercat.cat:10459.1/631392026-05-29T05:05:01Z
dc.title.none.fl_str_mv Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
Predictors of subclinical atheromatosis progression in patients at diferent stages of chronic kidney disease after two years of follow-up. The Nefrona study
title Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
spellingShingle Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
Gracia, Marta
Atherosclerosis
Chronic kidney disease
Cardiovascular disease
Vitamin D deficiency
title_short Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
title_full Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
title_fullStr Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
title_full_unstemmed Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
title_sort Predictors of Subclinical Atheromatosis Progression over 2 Years in Patients with Different Stages of CKD
dc.creator.none.fl_str_mv Gracia, Marta
Betriu i Bars, M. Àngels
Martínez Alonso, Montserrat
Arroyo, David
Abajo, María
Fernández i Giráldez, Elvira
Valdivielso Revilla, José Manuel
author Gracia, Marta
author_facet Gracia, Marta
Betriu i Bars, M. Àngels
Martínez Alonso, Montserrat
Arroyo, David
Abajo, María
Fernández i Giráldez, Elvira
Valdivielso Revilla, José Manuel
author_role author
author2 Betriu i Bars, M. Àngels
Martínez Alonso, Montserrat
Arroyo, David
Abajo, María
Fernández i Giráldez, Elvira
Valdivielso Revilla, José Manuel
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Atherosclerosis
Chronic kidney disease
Cardiovascular disease
Vitamin D deficiency
topic Atherosclerosis
Chronic kidney disease
Cardiovascular disease
Vitamin D deficiency
description Background and objectives Ultrasonographic detection of subclinical atheromatosis is a noninvasive method predicting cardiovascular events. Risk factors predicting atheromatosis progression in CKD are unknown. Predictors of atheromatosis progression were evaluated in patients with CKD. Design, setting, participants, & measurements Our multicenter, prospective, observational study included 1553 patients with CKD (2009-2011). Carotid and femoral ultrasounds were performed at baseline and after 24 months. A subgroup of 476 patients with CKD was also randomized to undergo ultrasound examination at 12 months. Progression of atheromatosis was defined as an increase in the number of plaque territories analyzed by multivariate logistic regression. Results Prevalence of atheromatosis was 68.7% and progressed in 59.8% of patients after 24 months. CKD progression was associated with atheromatosis progression, suggesting a close association between pathologies. Variables significantly predicting atheromatosis progression, independent from CKD stages, were diabetes and two interactions of age with ferritin and plaque at baseline. Given that multiple interactions were found between CKD stage and age, phosphate, smoking, dyslipidemia, body mass index, systolic BP (SBP), carotid intima-n-iedia thickness, plaque at baseline, uric acid, cholesterol, 25-hydroxy vitamin D (250H vitamin D), and antiplatelet and phosphate binders use, the analysis was stratified by CKD stages. In stage 3, two interactions (age with phosphate and plaque at baseline) were found, and smoking, diabetes, SBP, low levels of 25OH vitamin D, and no treatment with phosphate binders were positively associated with atheromatosis progression. In stages 4 and 5, three interactions (age with ferritin and plaque and plaque with smoking) were found, and SBP was positively associated with atheromatosis progression. In dialysis, an interaction between body mass index and 25OH vitamin D was found, and age, dyslipidemia, carotid intima-media thickness, low cholesterol, ferritin, and uric acid were positively associated with atheromatosis progression. Conclusions Atheromatosis progression affects more than one half of patients with CKD, and predictive factors differ depending on CKD stage.
publishDate 2016
dc.date.none.fl_str_mv 2016
2018
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://doi.org/10.2215/CJN.01240215
http://hdl.handle.net/10459.1/63139
http://hdl.handle.net/10459.1/63139
url https://doi.org/10.2215/CJN.01240215
http://hdl.handle.net/10459.1/63139
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.2215/CJN.01240215
Clinical Journal of The American Society of Nephrology, 2016, vol. 11, num. 2, p. 287-296
dc.rights.none.fl_str_mv (c) American Society of Nephrology, 2016
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) American Society of Nephrology, 2016
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American Society of Nephrology
publisher.none.fl_str_mv American Society of Nephrology
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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