Why the study?
Cardiovascular risk is significantly enhanced in chronic kidney disease, and carotid atherosclerosis serves as an early indicator of systemic vascular damage.
Primary prevention of carotid atherosclerosis in CKD should prioritize optimal risk factor management (blood pressure, lipids, lifestyle) over routine carotid imaging and antiplatelet therapy, which lack proven benefit and may cause harm.
Answers are grounded in this paper and cite their sources.
Stage-specific primary prevention is warranted now; extends current evidence to risk-adapted carotid management in CKD.
The cardiovascular risk imposed by chronic kidney disease is significantly enhanced, and carotid atherosclerosis is an early indicator of systemic vascular damage. In this review, we summarize available data relative to primary prevention strategies for carotid atherosclerosis in chronic kidney disease (CKD) with a focus on risk-adapted and stage-specific management. We conducted a narrative review of the literature. A structured literature search was performed in major databases (PubMed, Scopus, Web of Science and Google Scholar), focusing on studies published between 2012 and 2025, including observational studies, randomized controlled trials, and international guideline recommendations. The review focuses on blood pressure management, lipid-lowering therapy, glycemic control, antiplatelet therapy, as well as lifestyle interventions and screening strategies in patients with CKD without a history of cerebrovascular events. CKD-specific processes, such as inflammation, endothelial dysfunction and vascular calcification, may influence the progression of carotid plaques, highlighting the need to improve traditional and non-traditional risk factor management. The focus of prevention continues to emphasize blood pressure (BP) and lipid control as well. At the same time, routine carotid screening and systematically implemented antiplatelet therapy have no known benefit, but the potential for elevated bleeding risk, especially in advanced CKD. Primary prevention should therefore focus on optimal medical treatment, as well as disease-specific strategies according to CKD stage. Additional CKD-specific studies with carotid endpoints are necessary.
No takes yet. Share an insight, caveat, or question.
A 2026 study studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: