# Carotid Intima-Media Thickness in Chronic Kidney Disease: Evidence of Early Vascular Injury in a Tertiary Care Cohort in Northeast India

## TL;DR

This study shows that early vascular damage is common in chronic kidney disease patients in Northeast India, even at younger ages.

## Contribution

The study provides new evidence on early vascular injury in CKD from a tertiary care cohort in Northeast India.

## Key findings

- 76.3% of CKD patients had abnormal carotid intima-media thickness (CIMT) values.
- Significantly higher CIMT was observed in patients receiving hemodialysis.
- Advanced CKD stage, hemodialysis, and hypertension were independently associated with higher CIMT.

## Abstract

Background

Chronic kidney disease (CKD) is associated with a markedly increased cardiovascular risk that is often underestimated by traditional risk prediction models. Carotid intima-media thickness (CIMT) is a noninvasive marker of subclinical vascular injury, but data from Northeast India remain limited.

Methods

We conducted a cross-sectional study of 160 adults with CKD stages I to V attending a tertiary care center in Northeast India. Patients with a prior history of myocardial infarction, stroke, or vascular revascularization were excluded. CIMT was measured bilaterally using high-resolution B-mode ultrasonography, with three measurements obtained on each side and averaged to derive a participant-level mean. Abnormal CIMT was defined a priori as greater than 0.9 mm. Associations between CIMT and clinical variables were evaluated using multivariable linear regression adjusted for age, sex, CKD stage, hemodialysis status, hypertension, diabetes mellitus, and smoking.

Results

The mean age of participants was 40.3 ± 11.7 years, and 71.3% were male. Stage V CKD was the most common stage, accounting for 40.6% of patients. The overall mean CIMT was 1.04 ± 0.26 mm, and abnormal values were present in 122 of 160 participants (76.3%). Mean CIMT exceeded 0.9 mm by stage IIIa CKD. Patients receiving hemodialysis had significantly higher CIMT compared with those not on hemodialysis. In adjusted analyses, more advanced CKD stage, hemodialysis status, hypertension, and older age were independently associated with higher CIMT, while sex, diabetes mellitus, and smoking were not.

Conclusions

In this relatively young CKD cohort, a high burden of subclinical vascular injury was observed, with clinically significant carotid wall thickening detectable by stage IIIa. These findings support the use of CIMT as a practical adjunct for cardiovascular risk assessment in patients with CKD in resource-constrained settings.