Key result
Primary glomerulonephritis is linked to higher carotid intima-media thickness vs. healthy controls.
Why the study?
To evaluate the main markers of atherosclerosis and endothelial dysfunction in patients with primary glomerulonephritis, and whether early mineral and bone disorder influences this risk.
Do patients with primary glomerulonephritis have increased surrogate markers of atherosclerosis compared to healthy controls?
Cross-Sectional (n=134)
No
Do patients with primary glomerulonephritis have increased surrogate markers of atherosclerosis compared to healthy controls?
Absolute Event Rate: 0.66% vs 0.6%
p-value: p=0.003
Patients with primary glomerulonephritis have increased carotid intima-media thickness compared to controls, indicating higher cardiovascular risk which appears primarily associated with traditional risk factors like age and hypertension.
May support heightened CV surveillance in primary glomerulonephritis; leaves open whether disease-specific factors drive CIMT beyond traditional risks.
INTRODUCTION: Glomerulonephritis are the third cause of chronic kidney disease (CKD) requiring dialysis in Brazil. Mineral and bone disorder (MBD) is one of the complications of CKD and is already present in the early stages. Assessment of carotid intima-media thickness (CIMT) and flow-mediated vasodilatation (FMV) are non-invasive ways of assessing cardiovascular risk. HYPOTHESIS: Patients with primary glomerulonephritis (PG) have high prevalence of atherosclerosis and endothelial dysfunction, not fully explained by traditional risk factors, but probably influenced by the early onset of MBD. OBJECTIVE: To evaluate the main markers of atherosclerosis in patients with PG. METHOD: Clinical, observational, cross-sectional and controlled study. Patients with PG were included and those under 18 years of age, pregnants, those with less than three months of follow-up and those with secondary glomerulonephritis were excluded. Those who, at the time of exams collection, had proteinuria higher than 6 grams/24 hours and using prednisone at doses higher than 0.2 mg/kg/day were also excluded. RESULTS: 95 patients were included, 88 collected the exams, 1 was excluded and 23 did not undergo the ultrasound scan. Patients with PG had a higher mean CIMT compared to controls (0.66 versus 0.60), p = 0.003. After multivariate analysis, age and values for systolic blood pressure (SBP), FMV and GFR (p = 0.02); and FMV and serum uric acid (p = 0.048) remained statistically relevant. DISCUSSION AND CONCLUSION: The higher cardiovascular risk in patients with PG was not explained by early MBD. Randomized and multicentric clinical studies are necessary to better assess this hypothesis.
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Hagemann et al. (2023) conducted a cross-sectional in Primary glomerulonephritis (n=134). Primary glomerulonephritis vs. Healthy volunteers was evaluated on Carotid intima-media thickness (CIMT) (p=0.003). Patients with primary glomerulonephritis had a significantly higher mean carotid intima-media thickness compared to healthy controls (0.66 mm vs 0.60 mm, p=0.003).
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