Screening for asymptomatic carotid and peripheral atherosclerosis in chronic kidney disease patients with coronary artery disease

Background: Chronic kidney disease (CKD) affects about 10% of the worldwide population and is associated with increased morbidity and mortality. Doppler ultrasound is a simple bedside tool that can detect atherosclerosis in different vascular beds. Aim of the study: screening for the presence of subclinical asymptomatic carotid and peripheral atherosclerosis in patients with CKD with documented coronary atherosclerosis.Subjects and methods: Patients with established diagnosis of CKD and documented coronary artery disease with no history of carotid or peripheral arterial disease were recruited. Carotid and femoral arterial duplex were done to detect the presence of asymptomatic atherosclerosis.Results: A total of 110 patients were recruited. The mean age of the patients was 59 years and they were predominantly males. Dyslipidemia and hypertension were the most common atherosclerotic risk factors exceeding 80% of the patients. About 84% of the patients had evidence of diffuse carotid atherosclerosis while 83% of them had evidence of diffuse femoral atherosclerosis. The prevalence of carotid and femoral atherosclerotic plaques was around 50%. The independent predictors of increased CCA IMT were higher body weight and elevated TG levels. The independent predictors of increased femoral IMT were presence of hypertension, elevated levels of LDL-C and lower levels of HDL-C. Conclusion: Asymptomatic carotid and peripheral atherosclerosis are common among patients with CKD and established CAD. The traditional atherosclerotic risk factors are important mechanistics for the development of carotid and peripheral atherosclerosis in this patient group.