Prevalence, correlates and predictors of carotid intima media thickness among Nigerian chronic kidney disease patients

Abstract

Background: Chronic kidney disease (CKD) is a major public health burden with global increase in prevalence, morbidity and mortality. Cardiovascular disease is the major cause of morbidity and early mortality in chronic kidney disease patients. Carotid intima media thickness (CIMT) correlates with future cardiovascular and cerebrovascular events and measurement of CIMT has been suggested as a suitable, valuable and evidence-based tool to predict and evaluate cardiovascular risk. The study assessed the prevalence, correlates and predictors of CIMT among CKD patients attending Usmanu Danfodiyo University Teaching Hospital Sokoto.

Methods: The study was cross-sectional in design. A total of 80 CKD patients and 80 healthy control subjects were enrolled. Socio-demographic, clinical and laboratory data were obtained using a structured proforma. CIMT was measured using 7.5MHZ linear probe in B mode regime and dynamic range set at 60db. An average of six measurements; 3 from each side of the carotid was taken as the final CIMT. Clinical and laboratory data were collected using a structured proforma. Data was analysed using SPSS version 25.

Results: The prevalence of increased CIMT among CKD patients was 63.7% and a statistically significant difference in mean CIMT between the CKD group 0.96±0.15mm and control 0.5±0.15mm, p-value< 0.001. The mean CIMT increased across the stage of CKD with a statistically significant difference, p-value<0.01. There was no statistically significant difference in CIMT across aetiology of CKD. A positive correlation existed between increased CIMT measurements with age, serum creatinine, intact parathyroid hormone and high
sensitivity C-reactive protein (hsCRP) but a strong negative correlation was observed between CIMT and eGFR. Using multiple linear regression, the strongest predictor of CIMT was found to be hsCRP.

Conclusion: There is a significantly higher CIMT measurements in CKD patients compared to age and gender matched controls.