Peculiarities of vascular remodeling in patients with chronic kidney disease stage 5D: prognostic role of the intima-media thickness


DOI: https://dx.doi.org/10.18565/nephrology.2021.3.31-37

M.N. Kolomyitseva, M.Z. Gasanov, M.M. Batyushin, O.M. Manukyan, L.I. Rudenko

1) Rostov State Medical University, Department of Internal Diseases №2, Rostov-on-Don, Russia; 2) Rostov State Medical University, Department of Internal Diseases №1, Rostov-on-Don, Russia; 3) Rostov State Medical University, Department of Cardiology, Rheumatology and Functional Diagnostics, Rostov-on-Don, Russia; 4) Regional Consultative and Diagnostic Center, advisory department, Rostov-on-Don, Russia
Objective. To assess the factors influence the intima-media thickness (IMT) in patients with CKD stage 5D, as a key marker of vascular remodeling, reflecting the severity of endothelial dysfunction.
Material and methods. The study included 40 patients (22 men and 18 women) with chronic kidney disease receiving hemodialysis (HD) treatment. The average age of the patients was 58.9±13.1 years. The mean duration of the disease leading to end-stage renal disease (ESRD) was 10.9±1.5 years, the mean duration of renal replacement therapy (RRT) was 53.6±7.5 months. In all patients, clinical and anamnestic data were assessed, laboratory studies, bioimpedansometry were performed, ultrasound examination of the carotid arteries was performed, and the IMT was determined. Statistical analysis was performed using Statistica 10.0 software.
Results. It was found that with age in patients with CKD 5D, the IMT of the common carotid artery (CCA) increased (r=0.55; p<0.05). The duration of renal dysfunction was associated with an increase in CCA IMT (r=0.19; p<0.05). An increase in the CCA IMT was found in hypoalbuminemia, hyperglycemia, as well as an increase in the level of IL-6. The survival rate of patients in the group 2 years after the start of follow-up was 80%. When assessing the CCA IMT, it was found that among the deceased, this indicator was significantly higher than in the group of survivors and amounted to 1.02±0.11 mm versus 0.8±0.4 mm, respectively (p<0.05).
Conclusion. Thus, an increase in IL-6 levels, duration of CKD, electrolyte imbalance, hypoalbuminemia, hyperglycemia, and an increase in renal arterial vascular resistance were accompanied by an increase in the likelihood of an increase in CCA IMT. Increased in CCA IMT has also been associated with a poor prognosis.

About the Autors


Kolomyitseva Marina N. – post-graduate student of the Department of Internal Diseases #2, Rostov-on-Don, Russia; e-mail: marina_matlaeva@mail.ru;
ORCID: 0000-0001-6905-6115.
Gasanov Mitkhat Z. – Cand.Sci. (Med.), Associate Professor of the Department of Internal Diseases #1, Rostov state medical University, Rostov-on-Don, Russia;
e-mail: mitkhat@mail.ru; ORCID: 0000-0001-5856-0404.
Batyushin Mikhail M. – Dr. Sci. (Med.), Professor, Professor of the Department of Internal Diseases #2, Rostov state medical University, Rostov-on-Don, Russia;
e-mail: batjushin-m@rambler.ru; ORCID: 0000-0002-2733-4524.
Manukyan Ogannes M. – Resident of the Department of Cardiology, Rheumatology and Functional Diagnostics, Rostov State Medical University, Rostov-on-Don, Russia; e-mail: hovo59@yandex.ru; ORCID: 0000-0002-3328-2556.
Rudenko Liliya I. – Cand.Sci. (Med.), nephrologist of the Regional Consultative and Diagnostic Center, Rostov-on-Don; e-mail: rudenko.liliya@mail.ru;
ORCID: 0000-0002-9200-8565.


Similar Articles


Бионика Медиа