Key result
Chronic renal failure is associated with ~10% higher carotid integrated backscatter index versus healthy controls.
Why the study?
The ultrasonic reflectivity of the carotid wall as a prognostic marker in chronic renal failure patients without cardiovascular complications was not well characterized.
Case-Control (n=60)
Absolute Event Rate: 31.7% vs 28.9%
p-value: p=< 0.001
IBS may detect subclinical carotid changes in asymptomatic CRF; leaves open prognostic value pending prospective validation.
The ultrasonic reflectivity of the carotid wall, measured by means of integrated backscatter (IBS) analysis, has recently been evaluated in patients with atherosclerotic diseases and it was considered to be a prognostic marker. We performed B-mode measurement and IBS analysis of the carotid wall in 30 chronic renal failure (CRF) patients (serum creatinine 548 +/- 230 micromol/l) on conservative treatment and free of clinical evidence of cardiovascular complications; 14 were normotensives (NT) and 16 were treated hypertensives (TH). Thirty sex- and age-matched healthy subjects served as controls. The IBS carotid index was significantly higher in CRF patients than in controls (31.7 +/- 3.5 vs. 28.9 +/- 2.3 dB; p < 0.001), and no difference was observed between TH and NT CRF patients. The IBS index was negatively correlated with low-density lipoprotein cholesterol plasma levels (r = -0.46, p < 0.05), and within the group of TH CRF patients the IBS index was also negatively correlated with the body mass index and diastolic blood pressure. The carotid intima-media thickness was similar between uremic patients and controls. This study demonstrates an increment in carotid ultrasonic reflectivity in CRF patients, independent of the presence of overt atherosclerotic damage, and probably related to vascular remodelling linked to CRF. IBS analysis can be a useful tool to detect early changes in arterial wall structure. However, prospective studies should be planned to define its prognostic importance in uremic patients.
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Rossi et al. (2002) conducted a case-control in Chronic renal failure (n=60). Chronic renal failure vs. Healthy subjects was evaluated on Integrated backscatter (IBS) carotid index (p=< 0.001). Chronic renal failure was associated with a significantly higher integrated backscatter carotid index compared to healthy controls (31.7 vs. 28.9 dB; p < 0.001).
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