Aspects of carotid structure and function in health and different stages of chronic kidney disease

Anna, Moiseeva; Wallquist, Carin; Rickenlund, Anette; Hylander, Britta; Jacobson, Stefan H.; Caidahl, Kenneth; Eriksson, Maria

doi:10.1111/cpf.12429

Cited by 7 publications

(11 citation statements)

References 32 publications

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“…Carotid artery ultrasound was performed to assess arterial stiffness. Measurements of the diameter of the right common carotid artery and calculations of the pressure strain elastic modulus (Ep) were performed according to a standardized protocol [33].…”

Section: Methodsmentioning

confidence: 99%

Gradual reduction in exercise capacity in chronic kidney disease is associated with systemic oxygen delivery factors

et al. 2018

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BackgroundThe cause of reduced exercise capacity (ExCap) in chronic kidney disease (CKD) is multifactorial. The aim of this study was to investigate determinants of aerobic ExCap in patients with mild to severe CKD not undergoing dialysis.MethodsWe included 52 individuals with CKD stage 2–3, 47 with stage 4–5, and 54 healthy controls. Peak workload and peak heart rate (HR) were assessed by a maximal cycle exercise test. Cardiac function including stroke volume (SV) and vascular stiffness were evaluated by ultrasound at rest. Handgrip strength, body composition, haemoglobin level and self-reported physical activity were assessed.ResultsPeak workload (221±60, 185±59, 150±54 W for controls, CKD 2–3 and CKD 4–5 respectively), peak HR (177±11, 161±24, 144±31 beats/min) and haemoglobin level (14.2±1.2, 13.5±1.4, 12.2±1.3 g/dL) were all three significantly lower in CKD 2–3 than in controls, (p = 0.001, 0.001 and 0.03 respectively) and were even lower in stages 4–5 CKD than in CKD 2–3 (p = 0.01, 0.001 and <0.001 respectively). Resting SV and lean body mass did not differ between groups and handgrip strength was significantly lower only in CKD 4–5 compared to controls (p = 0.02). Peak workload was strongly associated with the systemic oxygen delivery factors: SV, peak HR and haemoglobin level. These three factors along with age, sex and height2 explained 82% of variation in peak workload. Peak HR contributed most to the variation; the peripheral variables handgrip strength and vascular stiffness did not improve the explanatory value in regression analysis.ConclusionsIn this cross-sectional study of CKD patients not on dialysis, aerobic ExCap decreased gradually with disease severity. ExCap was associated mainly with systemic oxygen delivery factors, in particular peak HR. Neither muscle function and mass, nor vascular stiffness were independent determinants of aerobic ExCap in this group of CKD patients.

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Section: Methodsmentioning

confidence: 99%

Gradual reduction in exercise capacity in chronic kidney disease is associated with systemic oxygen delivery factors

et al. 2018

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“…The methodological details have been described previously (Jensen-Urstad & Rosfors, 1997;Asp et al, 2015;Asp et al, 2018). The methodological details have been described previously (Jensen-Urstad & Rosfors, 1997;Asp et al, 2015;Asp et al, 2018).…”

Section: Ultrasound Examinationsmentioning

confidence: 99%

“…The ultrasound examinations were performed by two experienced sonographers, using an ultrasound machine (Sequoia 512; Siemens Medical Solutions, Mountain View, CA, USA) with an appropriate transducer. The methodological details have been described previously (Jensen-Urstad & Rosfors, 1997;Asp et al, 2015;Asp et al, 2018).…”

Section: Ultrasound Examinationsmentioning

confidence: 99%

Cardiovascular changes in patients with mild‐to‐moderate chronic kidney disease compared with healthy subjects: a 5‐year follow‐up study

Anna¹,

Wallquist²,

Rickenlund³

et al. 2019

Clin Physio Funct Imaging

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Background There is limited knowledge about how cardiovascular parameters change over time in patients with mild-to-moderate chronic kidney disease (CKD). We studied several cardiovascular biomarkers over a 5-year period in patients with mild-to-moderate CKD and in healthy controls. Methods Fifty-four patients with CKD stages 2-3 and 54 controls were included. The CKD patients were closely monitored and well controlled for hypertension and other cardiovascular risk factors. Ambulatory blood pressure (BP) monitoring, ankle-brachial index (ABI), carotid and cardiac ultrasound (including measurement of the left ventricular mass index (LVMI)), and biochemical analyses were evaluated. Results Renal function decreased in both groups, with no significant difference in the change over time. In the CKD patients, none of the BP variables increased over time, but in the controls, average 24-h and daytime systolic BP increased significantly. ABI increased slightly in the CKD patients (P<0Á001), but not in the controls (P = 0Á963), and phosphate had a significant positive effect on ABI. Although in the CKD patients, there was no significant increase over time in common carotid artery diameter (P = 0Á274), there was a small but significant increase in the controls (P = 0Á001). LVMI increased significantly over time in both groups. Conclusions In our study of patients with mild-to-moderate CKD, the progression of cardiovascular changes over time was relatively slow. Good BP control and treatment of other risk factors may have contributed to slow the progress of cardiovascular involvement, which emphasizes the importance of dedicated care in this population.

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“…CKD was shown to be an independent risk factor for carotid atherosclerosis, 8 and increased cIMT is associated with early-stage 20 and advanced CKD. 21 cIMT is considered a surrogate for cardiovascular disease and is a variable predictor of stroke and cardiovascular events. 22 – 24 Our original cohort also showed a high prevalence of cognitive function decline and CSVD in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Carotid intima–media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease

Zheng

Qian

Lin

et al. 2020

Therapeutic Advances in Chronic Disease

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Background: Carotid intima–media thickness (cIMT) is considered a risk factor for and predictor of cerebrovascular disease. In this study, we explored the contribution of cIMT to cognitive impairment (CI) in dialysis patients and the role of cerebral small vascular disease (CSVD) and brain atrophy in this process. Methods: Cognitive function was assessed using a comprehensive cognitive test battery. CSVD and brain volume were assessed by magnetic resonance imaging, and cIMT was measured by ultrasonography. Multivariable analysis and mediation were used to explore the relevant relationships among cIMT, CI, CSVD and brain volume. Results: Seventy-three dialysis patients were enrolled. Approximately 54.8% were diagnosed with increased cIMT. The increased cIMT group was older and had lower serum albumin and creatinine levels than the normal cIMT group. There was no difference in the CSVD prevalence between the different cIMT groups. Patients in the normal, unilaterally and bilaterally increased cIMT subgroups demonstrated a gradual decrease in brain-matter volume and degenerate cognitive function. cIMT was related to cognitive function and gray-/white-matter volume. Increased cIMT was associated with a significantly increased risk of a reduced Mini Mental State Examination/Montreal Cognitive Assessment score and Trail A/B time delay. Mediation analysis showed that CI was mediated by brain-matter volume but not by CSVD. Conclusion: Increased cIMT was an independent risk factor for impairment of global cognitive function, memory, and executive function. The impact of cIMT on cognition was not induced by CSVD but by brain atrophy. cIMT may be a useful tool for screening patients at high risk of CI in the dialysis population.

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Aspects of carotid structure and function in health and different stages of chronic kidney disease

Cited by 7 publications

References 32 publications

Gradual reduction in exercise capacity in chronic kidney disease is associated with systemic oxygen delivery factors

Gradual reduction in exercise capacity in chronic kidney disease is associated with systemic oxygen delivery factors

Cardiovascular changes in patients with mild‐to‐moderate chronic kidney disease compared with healthy subjects: a 5‐year follow‐up study

Carotid intima–media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease

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