Rudenko T E, Kutyrina I M, Kushnir V V, Shvetsov M Iu
Ter Arkh. 2005;77(6):46-50.
To examine changes in the structure of large (carotid and femoral) arteries at an early stage of chronic renal failure (CRF) and factors significant for their development.
Duplex ultrasonography of the common carotid arteries (CCA) and common femoral arteries (CFA), serum biochemical tests, echocardiography were made in 32 patients (15 males and 17 females) with chronic diffuse renal disease at an initial stage of CRF (creatinine 2.7 mg%, CRF duration 2.7 years). Increased thickness of the intima-media complex (IMC) in both vascular territories was found in 72% of the examinees. There was a close correlation between CCA and CFA IMC (chi-square = 14.05; p = 0.0002). Plaques in the carotid arteries correlated with smoking (chi-square = 4.60; p = 0.0320), in the femoral arteries--with male sex (chi-square = 5.18; p = 0.0228). IMC of both arteries correlated with age (r = 0.49 and r = 50, respectively, p < 0.05), body mass index (r = 0.50, p < 0.05), thickness of the left ventricular posterior wall and interventricular septum (r = 0.65 and r = 0.55, respectively, p < 0.05), CFA IMC correlated also with creatinine level (r = 0.39, p < 0.05), hypertriglyceridemia (chi-square = 10.33; p = 0.0013), systolic, pulse and mean arterial pressure (r = 0.45, r = 0.38, r = 0.36, respectively, p < 0.05), smoking (r = 0.48, r = 0.40, respectively, p < 0.05) and family history of cardiovascular diseases (chi-square = 7.16; p = 0.0075). A linear multifactorial regression analysis has detected that an independent factor of increased CCA and CFA IMC in patients under 50 years of age was creatinine, in patients over 50 years--age.
Even at early stages of renal failure patients have thicker IMC associated with both standard risk factors (age, hypertension, smoking, lipid disbolism) and development of renal failure itself.