Avaliacao da espessura medio-intimal em pacientes com doenca renal cronica nao dialitica: estudo prospectivo de 24 meses

• Autor(a) principal: Marcos, Andrea Gaspar
• Data de Publicação: 2014
• Outros Autores: Watanabe, Renato, Lemos, Marcelo Montebello [UNIFESP], Canziani, Maria Eugênia Fernandes [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/0013000003g61
• DOI: 10.5935/0101-2800.20140007
• Texto Completo: http://dx.doi.org/10.5935/0101-2800.20140007; http://repositorio.unifesp.br/handle/11600/8277
• topic: cardiovascular diseases; carotid intima-media thickness; mortality; renal insufficiency; chronic; doencas cardiovasculares; espessura intima-media carotidea; insuficiencia renal cronica; mortalidade

Introduction:Increased carotid intima-media thickness (IMT) is considered a marker of early-onset atherosclerosis and it seems to predict cardiovascular events in general population. The prognostic value of IMT in patients with early-stage chronic kidney disease (CKD) has not been clearly established.Objective:We aimed to evaluate the association between IMT and cardiovascular (CV) events and mortality in CKD patients.Methods:A cohort of CKD patients in stage 2-4 was evaluated the occurrence of CV events and death in a 24 months follow-up. Laboratory data, carotid ultrasound and coronary computed tomography were performed at baseline.Results:A total of 117 patients (57 ± 11 years-old, 61% male) were evaluated. Mean glomerular filtration rate (eGFR) was 36 ± 17 mL/min, 96% of patients had hypertension, 23% diabetes and 27% were obese. Coronary calcification was found in 48% of the patients, with higher prevalence among CKD stage 4 (p = 0.02). The median value of IMT was 0.6 mm (0.4-0.7 mm). When compared to patients with IMT ≤ 0.6 mm, those with IMT > 0.6 mm were older (p = 0.001), had higher prevalence of male (p = 0.001) and had lower eGFR (p = 0.01). These patients also had higher prevalence of coronary calcification (p = 0.001). During the follow-up, there were no differences in the occurrence of cardiovascular events and deaths between the two groups.Conclusion:IMT in early-stage CKD patients was related to coronary calcification, but not with the occurrence of cardiovascular events or death.