Carotid atherosclerosis in renal transplant recipients - Relationships with cardiovascular risk factors and plasma lipoproteins

Background. Renal transplant recipients have an increased incidence of card iovascular disease, but less data exist about cerebrovascular atheroscleros is. In this study, we assessed the prevalence of carotid lesions as evaluat ed by B-mode ultrasonography in a group of renal transplant recipients, and we evaluated univariate and multivariate relationships between common risk factors and plasma lipoproteins and carotid lesions. Methods. Fifty-seven renal transplant recipients and 113 age- and gender-ma tched controls underwent a complete clinical visit for the evaluation of ri sk factors present. In all subjects, a blood sample was collected for Lipop rotein determination, and an ultrasound high-resolution B-mode imaging exam ination of the common carotid arteries was performed. Results. we found that among renal transplant recipients, there was a signi ficantly increased prevalence of subjects with plaque in comparison with co ntrols (24.6% vs. 6.2%, P < 0.001). At multiple analysis, carotid lesions w ere independently associated with age, hypertension, diabetes, smoking habi t, and the presence of cardiovascular disease in controls and with age and hypertension in renal transplant recipients. Neither the lipid profile nor the presence of dyslipidemias was related to carotid score in renal transpl ant recipients, whereas a nonsignificant trend was observed in controls. Fi nally, in transplant patients, we did not find any association between caro tid lesions and high-density Lipoprotein subfractions. Conclusions. Age and hypertension are the main predictors of extracranial c erebrovascular atherosclerosis after renal transplantation. Because carotid lesions may represent a useful predictive marker of clinical events in non transplant subjects, carotid artery evaluation by B-mode ultrasound might b e routinely included in the management of renal transplant patients.