Correlation of carotid artery intima–media thickness with parameters of mineral bone disorder in patients with chronic kidney disease

Background Chronic kidney disease (CKD) is associated with accelerated cardiovascular (CV) risk, particularly due to subclinical atherosclerosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of early athero-sclerotic changes. Altered mineral metabolism in CKD, also known as CKD-mineral bone disorder (CKD-MBD), may contribute to vascular damage. We evaluated the association between CIMT and mineral metabolism markers in people with diabetes who had pre-dialysis CKD. Methods A cross-sectional observational study was done in 110 adults with diabetes and pre-dialysis CKD. Biochemical markers including serum phosphate, intact parathyroid hormone (iPTH), fibroblast growth factor (FGF)-23, and 24-hour urinary phosphate were analyzed. CIMT was measured using B-mode ultrasonography. Correlation and regression analyses were performed. Results CIMT showed significant positive correlations with serum phosphate, FGF-23, iPTH, and serum creatinine, and negative correlations with nephron index and urinary phosphate excretion. Serum phosphate >6 mg/dl strongly predicted CIMT >0.9 mm. Conclusion Mineral metabolism markers, particularly serum phosphate and FGF-23, are significantly associated with subclinical atherosclerosis in CKD. Monitoring these parameters may aid in assessment of early CV risk in patients with CKD.