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

Background: 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. Methods: 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. Results: 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 (r(partial) = 0.409; p < 0.001), male sex (r(partial) = 0.199; p < 0.001), and coronary artery disease (rpartial = 0.139; p < 0.01) independently increased IMT (R-2 = 0.25). For the occurrence of calcified carotid plaques, age (r(partial) = 0.544; p < 0.001), male gender (r(partial) = 0.127; p < 0.05), and the duration of renal insufficiency prior to transplantation (r(partial) = 0.235; p < 0.001) were confirmed as independent variables. Conclusions: 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.

Automated summary

Significant differences in carotid intima-media thickness (IMT) values and distribution of carotid plaques are present in stable kidney transplant recipients (KTRs). Age, gender, and coronary artery disease are independent factors associated with IMT, while age, gender, and duration of renal insufficiency before transplantation are confirmed as independent variables for the occurrence of calcified carotid plaques.