The Distribution And Influencing Factors Of Atherosclerosis In Chronic Kidney Disease

Background Chronic kidney disease(CKD) patients are at significantly higher risk for developing cardiovascular disease (CVD) as compared to healthy people. CVD is the most important factor which affect the prognosis of CKD patients. Atherosclerosis (AS) is the main pathological basis of CVD.Studying the distribution and influencing factors of AS in CKD patients plays a vital role in the detection and intervention of CVD at early time.Recent studies have found that chronic inflammation plays a key role in the pathogenesis of As. Micro-inflammatory state is common in patients with CKD.It can promote the occurrence and development of AS. Pentraxin3(PTX3) is a newly discovered markers of inflammation. There is few data on PTX3with AS in CKD patients.Objective To study the distribution and influencing factors of AS in CKD patients and explore the relationship between plasma long pentraxin3(PTX3) level and As.Methods A total of152non-dialytic CKD patients in our hospital were enrolled in the study, and30age and gender matched healthy volunteers were used as control. Intima-media thickness (IMT) and atherosclerotic plaques of carotid artery were detected by high-resolution B-mode ultrasonography. Plasma level of PTX-3was measured using ELISA. Serum creatinine, albumin, uric acid, lipid profiles, high-sensitivity CRP (hsCRP),blood calcium, phosphorus and parathyroid hormone (PTH) were measured by our hospital. Spearman correlation and Logistic regression was performed to analyse the association between AS and PTX3as well as other potential risk factors.Result The incidence of carotid atherosclerosis in CKD patients was significantly higher as compared with that in the healthy controls (P<0.01) and increased across increasing CKD stages. In Spearman correlation, carotid atherosclerosis is positive related to age, history of diabetes, SBP, uric acid phosphorus and hsCRP,negative related to albumin. logistic regression analysis also indicates age, uric acid and hsCRP are independent risk factors of carotid atherosclerosis.Higher Plasma PTX3levels were found in patients with CKD as compared to healthy controls [(2.86±1.13ng/ml)vs(1.64±0.75ng/ml), P<0.05].The level of PTX3increased with the progression of renal dysfunction. Patiens with carotid atherosclerosis showed higher concentrations of PTX3than those patiens without carotid atherosclerosis [(4.36±2.48ng/ml) vs (2.34±1.85ng/ml) P<0.05].Plasma PTX3level was positively correlated with the carotid atherosclerosis incidence. Logistic regression analysis further indicated that PTX3(β=0.681, P=0.001) was an independent risk factor o f carotid atherosclerosis in CKD patients.Conclusion AS is common in CKD patients, even in the early stage of CKD. Increased plasma PTX3concentration is found in CKD patients and is losely associated with AS.PTX3may play a role in pathogenesis and progression of AS.