Atheroma Progression in Chronic Kidney Disease

Rigatto, Claudio; Levin, Adeera; House, Andrew A.; Barrett, Brendan; Carlisle, Euan; Fine, Adrian

doi:10.2215/cjn.01840408

Cited by 35 publications

(20 citation statements)

References 24 publications

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“…When we categorized the patients by CKD stage, 29 patients (10.8%) belonged to stage 3 and 48 patients (17.9%) were non-CKD stage 3 patients. There are reports that lipid-rich plaque formation progresses easily in patients presenting with CKD equivalent to stage 3 16,17) ; thus, we surveyed the stage 3 CKD patients.…”

Section: Methodsmentioning

confidence: 99%

Effects on Serum Uric Acid by Difference of the Renal Protective Effects with Atorvastatin and Rosuvastatin in Chronic Kidney Disease Patients

Kose

Kikkawa

et al. 2014

Biological & Pharmaceutical Bulletin

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Hyperuricemia and hyperlipidemia have attracted attention as progression factors for chronic kidney disease (CKD). In the drug treatment of hyperuricemia and hyperlipidemia complications, Atorvastatin (ATV), which inhibits urinary protein, increases glomerular filtration rate (GFR) and has renal protective effects, and Rosuvastatin (ROS) were found be suitable because they promote serum uric acid (SUA) excretion. However, these drugs were administered at very high doses in previous studies. In this study, we have investigated the effects of ATV or ROS on renal protective effects and their SUA levels before and three months after each drug administration in CKD patients. We retrospectively investigated outpatients presenting with CKD (stages 3) on the basis of their electronic medical records as subjects. Estimated GFR (eGFR) was significantly increased after ATV administration, whereas no change in eGFR was observed following ROS administration. Furthermore, SUA levels significantly decreased after ATV administration, whereas no changes were observed following ROS administration. Therefore, it may be not necessary to administer drugs that lower the SUA levels to patients presenting with hyperuricemia and hyperlipidemia complications associated with moderate renal failure, such as patients with at least stage 3 CKD. We consider that, by selecting ATV, the renal protective effects and SUA-lowering effect would be sufficient.

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Section: Methodsmentioning

confidence: 99%

Effects on Serum Uric Acid by Difference of the Renal Protective Effects with Atorvastatin and Rosuvastatin in Chronic Kidney Disease Patients

Kose

Kikkawa

et al. 2014

Biological & Pharmaceutical Bulletin

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“…However, it is uncertain what the velocity of atheromatosis progression in CKD is (22,23), and little is known about the predictors of plaque progression in patients with CKD. Only two studies have addressed this question: one with patients on dialysis (10) and one with a limited number of patients with CKD stage 3 or 4 with a short interval ultrasound control (22).…”

Section: Introductionmentioning

confidence: 99%

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

Gracia

Betriu

Martínez-Alonso

et al. 2016

Clinical Journal of the American Society of Nephrology

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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 (2009CKD ( -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-media thickness, plaque at baseline, uric acid, cholesterol, 25-hydroxy vitamin D (25OH 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.

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“…Aortic PWV was not correlated with the duration of hemodialysis. In a recent report from Italy 55) , the annual increase of the cross-sectional area of carotid atherosclerotic plaque was higher in CKD patients with CCr of 29-50 mL/min than in those with CCr of 20-29 decreased 42) . Patients with renal failure have an increased serum concentration of apoC-Ⅲ 43) , an inhibitor of LPL, as well as increased apoC-Ⅲ/C-Ⅱ ratio.…”

Section: Dyslipidemia In Ckdmentioning

confidence: 85%

Chronic Kidney Disease, Dyslipidemia, and Atherosclerosis

Shoji

Abe

Matsuo³

et al. 2012

JAT

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Patients with chronic kidney disease (CKD) are at an increased risk not only for end-stage kidney disease (ESKD) but also for cardiovascular disease (CVD). In this review article, we summarize the current evidence of CKD as a high-risk condition for CVD based on reports from Japan and other countries to draw attention to the close clinical association between CKD and CVD. Several epidemiologic studies have shown that the presence of CKD and reduced renal function are independent predictors of CVD also in Japan. According to a post-hoc analysis of CASE-J, the power of CKD as a predictor of CVD is as strong as diabetes mellitus and a previous history of ischemic heart disease. CKD worsens classical risk factors including hypertension and dyslipidemia, and dyslipidemia is associated with increased thickness and stiffness of large arteries independent of major confounders. A post-hoc analysis of MEGA indicates that lipid-lowering therapy with statins reduces the risk of CVD, and that it appears to be more efficacious in patients with than without CKD. These reports from Japan and other countries suggest that CKD should be regarded as a high-risk condition comparable to diabetes mellitus, and that strict control of dyslipidemia would be beneficial in preventing CVD, at least early stages of CKD.

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Atheroma Progression in Chronic Kidney Disease

Cited by 35 publications

References 24 publications

Effects on Serum Uric Acid by Difference of the Renal Protective Effects with Atorvastatin and Rosuvastatin in Chronic Kidney Disease Patients

Effects on Serum Uric Acid by Difference of the Renal Protective Effects with Atorvastatin and Rosuvastatin in Chronic Kidney Disease Patients

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

Chronic Kidney Disease, Dyslipidemia, and Atherosclerosis

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