CAROTID-ARTERY LESIONS IN PATIENTS WITH NONDIABETIC CHRONIC-RENAL-FAILURE

Atherosclerotic complications are the leading cause of death in chroni c renal failure (CRF) patients. Therefore, we wished to investigate th e prevalence of carotid artery lesions (CALs) in these subjects. Two g roups were evaluated by high-resolution echo Doppler: group 1 included 103 patients (68 males and 35 females) affected by nonnephrotic CRF a nd group 2 included 100 control subjects (60 males and 40 females). Th e prevalence of hypertension was 84% in both groups. The exclusion cri teria included diabetes mellitus and symptoms of cerebrovascular disea se. In the two groups we evaluated clinical history, physical examinat ion, total cholesterol, triglycerides, fibrinogen, blood cell counts, blood urea nitrogen, creatinine, 24-hour proteinuria, and urine analys is. In group 1 patients the following lipid profile parameters were al so evaluated: low-density lipoprotein cholesterol, high-density lipopr otein cholesterol, lipoprotein(a), ApoAl, ApoAll, and ApoB. Group 1 ha d higher triglycerides and fibrinogen than group 2. A lower body mass index was found in group 1 than in group 2. The prevalence of CALs was significantly higher in the CRF patients than in the control subjects (62% v 47%; P = 0.04). The difference between the two groups was more striking among normotensive patients (62% v 19%; P = 0.03). All CRF p atients affected by peripheral arterial disease and 86% of those havin g coronary artery disease had associated CALs. In CRF patients the sev erity of CALs was positively correlated to age, white blood cell count , triglycerides, and fibrinogen. Nondiabetic CRF patients have a highe r prevalence of carotid artery lesions than control subjects. Several factors besides hypertension, including lipids, blood coagulation, and leukocytes, could contribute to the accelerated atherosclerosis of CR F patients. (C) 1996 by the National Kidney Foundation, Inc.