Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes

Background and aims: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes. Traditional cardiovascular risk factors fail to fully account for the increase in cardiovascular risk in these patients. This study aims to analyse...

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Authors: Palanca, A, Castelblanco, E, Perpinan, H, Betriu, A, Soldevila, B, Valdivielso, JM, Bermudez, M, Duran, X, Fernandez, E, Puig-Domingo, M, Groop, PH, Alonso, N, Mauricio, D
Format: article
Status:Published version
Publication Date:2018
Country:España
Institution:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repository:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p3419
Online Access:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3419
Access Level:Open access
Keyword:Chronic kidney disease
Diabetes
Subclinical atherosclerosis
Cardiovascular outcomes
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spelling Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetesPalanca, ACastelblanco, EPerpinan, HBetriu, ASoldevila, BValdivielso, JMBermudez, MDuran, XFernandez, EPuig-Domingo, MGroop, PHAlonso, NMauricio, DChronic kidney diseaseDiabetesSubclinical atherosclerosisCardiovascular outcomesBackground and aims: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes. Traditional cardiovascular risk factors fail to fully account for the increase in cardiovascular risk in these patients. This study aims to analyse the prevalence and progression of subclinical atherosclerosis in CKD patients with and without diabetes. Methods: We included data from CKD patients with and without diabetes free from previous cardiovascular events from the NEFRONA cohort. Patients underwent baseline and 24-month follow-up carotid and femoral ultrasound examinations. Multivariable models were used to assess the contribution of diabetes to the presence and plaque progression. Results: A total of 419 patients with diabetes and 1129 without diabetes were included. Diabetic patients were older, had higher BMIs, more hypertension and dyslipidaemia. At baseline, the proportion of patients with plaque was higher among diabetic patients (81.4% vs. 64.1%, p < 0.001). Diabetic patients more frequently had more than two vascular territories with plaque (64.4% vs. 48.4%, p < 0.001). Multivariable analysis indicated that plaque at baseline was significantly associated with age, gender, smoking and renal replacement therapy (RRT) in the non-diabetic patients, but only with age and male gender in diabetic patients. Plaque progression was significantly associated with age, number of territories with basal plaque, smoking and RRT in both groups. Conclusions: Subclinical atherosclerosis is more prevalent, carries a higher plaque burden and is more rapidly progressive in renal patients with diabetes. In these patients, diabetes outweighs other described risk factors associated with the presence of subclinical atherosclerosis. (c) 2018 Elsevier B.V. All rights reserved.ELSEVIER IRELAND LTD2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3419ATHEROSCLEROSISISSN: 00219150ISSNe: 18791484reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p34192026-06-14T12:41:47Z
dc.title.none.fl_str_mv Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
title Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
spellingShingle Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
Palanca, A
Chronic kidney disease
Diabetes
Subclinical atherosclerosis
Cardiovascular outcomes
title_short Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
title_full Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
title_fullStr Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
title_full_unstemmed Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
title_sort Prevalence and progression of subclinical atherosclerosis in patients with chronic kidney disease and diabetes
dc.creator.none.fl_str_mv Palanca, A
Castelblanco, E
Perpinan, H
Betriu, A
Soldevila, B
Valdivielso, JM
Bermudez, M
Duran, X
Fernandez, E
Puig-Domingo, M
Groop, PH
Alonso, N
Mauricio, D
author Palanca, A
author_facet Palanca, A
Castelblanco, E
Perpinan, H
Betriu, A
Soldevila, B
Valdivielso, JM
Bermudez, M
Duran, X
Fernandez, E
Puig-Domingo, M
Groop, PH
Alonso, N
Mauricio, D
author_role author
author2 Castelblanco, E
Perpinan, H
Betriu, A
Soldevila, B
Valdivielso, JM
Bermudez, M
Duran, X
Fernandez, E
Puig-Domingo, M
Groop, PH
Alonso, N
Mauricio, D
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Chronic kidney disease
Diabetes
Subclinical atherosclerosis
Cardiovascular outcomes
topic Chronic kidney disease
Diabetes
Subclinical atherosclerosis
Cardiovascular outcomes
description Background and aims: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes. Traditional cardiovascular risk factors fail to fully account for the increase in cardiovascular risk in these patients. This study aims to analyse the prevalence and progression of subclinical atherosclerosis in CKD patients with and without diabetes. Methods: We included data from CKD patients with and without diabetes free from previous cardiovascular events from the NEFRONA cohort. Patients underwent baseline and 24-month follow-up carotid and femoral ultrasound examinations. Multivariable models were used to assess the contribution of diabetes to the presence and plaque progression. Results: A total of 419 patients with diabetes and 1129 without diabetes were included. Diabetic patients were older, had higher BMIs, more hypertension and dyslipidaemia. At baseline, the proportion of patients with plaque was higher among diabetic patients (81.4% vs. 64.1%, p < 0.001). Diabetic patients more frequently had more than two vascular territories with plaque (64.4% vs. 48.4%, p < 0.001). Multivariable analysis indicated that plaque at baseline was significantly associated with age, gender, smoking and renal replacement therapy (RRT) in the non-diabetic patients, but only with age and male gender in diabetic patients. Plaque progression was significantly associated with age, number of territories with basal plaque, smoking and RRT in both groups. Conclusions: Subclinical atherosclerosis is more prevalent, carries a higher plaque burden and is more rapidly progressive in renal patients with diabetes. In these patients, diabetes outweighs other described risk factors associated with the presence of subclinical atherosclerosis. (c) 2018 Elsevier B.V. All rights reserved.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3419
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3419
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER IRELAND LTD
publisher.none.fl_str_mv ELSEVIER IRELAND LTD
dc.source.none.fl_str_mv ATHEROSCLEROSIS
ISSN: 00219150
ISSNe: 18791484
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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