# 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.

## Key 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.