Chronic kidney disease is associated with increased carotid artery stiffness without morphological changes in participants of health check-up programs

Background and methods: Patients with chronic kidney disease (CKD) show a much higher risk of cardiovascular disease. However, the mechanisms underlying this association and the impact of CKD on behaviors of the vascular walls have not been fully clarified. Using ultrasonography, this study investigated associations of CKD (estimated glomerular filtration rate <60 ml/min/1.73m(2) and/or presence of proteinuria) with both elasticity (stiffness beta index) of the carotid artery and intimal atherosclerotic changes in participants of health check-up programs (n = 3406, 63% men; mean age, 58.8 years). Results: Stiffness beta was significantly higher in CKD subjects (7.49 +/- 0.14) than in non-CKD subjects (6.87 +/- 0.05, P < 0.001). This significant difference was maintained in a multiple adjusted model including conventional risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking and obesity (7.20 +/- 0.14 vs. 6.91 +/- 0.05, P = 0.043). No significant differences in intima-media complex thickness or plaque score were seen between CKD and non-CKD subjects. Conclusion: In participants of health check-up programs, CKD was associated with increased carotid arterial stiffness without intimal disease, independently of conventional risk factors. These findings indicate that CKD may predispose the carotid arteries to earlier development of arteriosclerosis, characterized by increased arterial stiffness. (C) 2010 Elsevier Ireland Ltd. All rights reserved.