Prevalence, Correlates and Predictors of Carotid Intima Media Thickness among Nigerian Chronic Kidney Disease Patients
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Abstract
Background: Chronic kidney disease (CKD) is a
major public health burden with global increase in
prevalence, morbidity and mortality. Cardiovascular
disease is the major cause of morbidity and early
mortality in chronic kidney disease patients. Carotid
intima media thickness (CIMT) correlates with future
cardiovascular and cerebrovascular events and
measurement of CIMT has been suggested as a
suitable, valuable and evidence-based tool to predict
and evaluate cardiovascular risk. The study assessed
the prevalence, correlates and predictors of CIMT
among CKD patients attending Usmanu Danfodiyo
University Teaching Hospital Sokoto.
Methods: The study was cross-sectional in design.
A total of 80 CKD patients and 80 healthy control
subjects were enrolled. Socio-demographic, clinical
and laboratory data were obtained using a structured
proforma. CIMT was measured using 7.5MHZ linear
probe in B mode regime and dynamic range set at
60db. An average of six measurements; 3 from each
side of the carotid was taken as the final CIMT.
Clinical and laboratory data were collected using a
structured proforma. Data was analysed using SPSS
version 25.
Results: The prevalence of increased CIMT among
CKD patients was 63.7% and a statistically significant
difference in mean CIMT between the CKD group
0.96±0.15mm and control 0.5±0.15mm, pvalue<
0.001. The mean CIMT increased across the stage of CKD with a statistically significant
difference, p-value<0.01. There was no statistically
significant difference in CIMT across aetiology of
CKD. A positive correlation existed between
increased CIMT measurements with age, serum
creatinine, intact parathyroid hormone and high
sensitivity C-reactive protein (hsCRP) but a strong
negative correlation was observed between CIMT
and eGFR. Using multiple linear regression, the
strongest predictor of CIMT was found to be hsCRP.
Conclusion: There is a significantly higher CIMT
measurements in CKD patients compared to age and
gender matched controls.