Carotid Plaques in CKD Patients Predicts Progression to Dialysis
ATLANTA—Carotid plaque predicts rapid decline in renal function and progression to dialysis among patients with stage 3 and 4 chronic kidney disease (CKD), according to study findings presented at the American Society of Nephrology's Kidney Week 2013 meeting.
Jwa-Kyung Kim, MD, of Hallym University Sacred Heart Hospital in Anyang, South Korea, enrolled 411 stage 3 and 4 CKD patients. All underwent carotid ultrasonography at the time of CKD diagnosis. Subjects had a baseline estimated glomerular filtration rate of 44.5 mL/min/1.73 m2. Carotid plaques were found in 282 patients (68.6%). These patients had significantly faster rates of renal function decline than those without carotid plaques (-3.64 vs. -1.20 mL/min/1.73 m2 per year.
During 2.5 years of follow-up, 47 patients (11.4%) started dialysis. Subjects with carotid plaques had a 3.3 times greater likelihood of progressing to dialysis than those without carotid plaques. Irregular plaque surfaces are particularly associated with a rapid decline of renal function.
Detecting carotid plaque may help identify patients at high risk for progression of renal dysfunction, the authors concluded.