Divergent Occurrence of Carotid Intima-Media Thickness and Carotid Arteries Plaques in Stable Kidney Transplant Recipients

TL;DR

This study finds that kidney transplant recipients often have uneven carotid artery thickness and plaque distribution, with different risk factors for each.

Contribution

The study identifies distinct clinical risk factors for carotid intima-media thickness and calcified plaques in kidney transplant recipients.

Findings

10.2% of patients showed significant side-to-side differences in carotid intima-media thickness.

26.8% of patients without carotid plaques on one side had calcified plaques on the other.

Age, male sex, and coronary artery disease are key risk factors for increased intima-media thickness.

Abstract

Carotid atherosclerosis is one of the main cerebrovascular
complications in kidney transplant recipients (KTRs). We analyzed the
relationships between carotid intima-media thickness (IMT) and the occurrence and
characteristics of carotid plaques in a cohort of KTRs.

In 500
KTRs (aged 49.9 ± 12.0 years), IMT was measured and carotid plaques were
semi-qualitatively assessed. Concomitantly, biochemical and hormonal
inflammatory, vascular and calcium-phosphate metabolism parameters were also
assessed.

In 10.2% of patients, a side-to-side IMT difference
>0.1 mm was observed, whereas 26.8% of patients with no plaques in one carotid
artery had at least one contralateral calcified plaque. Multivariate logistic
regression analysis revealed that age (rpartial = 0.409; p <
0.001), male sex (rpartial = 0.199; p < 0.001), and coronary
artery disease (rpartial = 0.139; p < 0.01) independently
increased IMT (R2 = 0.25). For the occurrence of calcified carotid plaques,
age (rpartial = 0.544; p < 0.001), male gender (rpartial =
0.127; p < 0.05), and the duration of renal insufficiency prior to
transplantation (rpartial = 0.235; p < 0.001) were confirmed as
independent variables.

Substantial side-to-side differences
in IMT values and carotid plaques distribution are present in a large percentage
of stable KTRs. In addition, there are different clinical risk factors profiles
associated with IMT and the presence of calcified plaques. Vascular and
calcium-phosphate metabolism biomarkers were not associated with any carotid
atherosclerosis characteristics.

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