Nephrosclerosis and carotid atherosclerosis: lessons from kidney donor histology.

ABSTRACT

AIM: Carotid artery intima media thickness (CA-IMT) measurement has been shown to be a safe and reproducible method to assess severity of atherosclerosis. The association between nephrosclerosis and systemic atherosclerosis is not clear. In this study, we investigated the association between CA-IMT and nephrosclerosis in a group of kidney transplant donors. METHODS: Forty seven potential kidney transplant donors were included. CA-IMT was measured by B-Mode ultrasonography. Kidney allograft biopsy samples were obtained during the transplantation operation and chronic glomerular, vascular and tubulointertitial changes were semiquantitatively scored according to the Banff classification. RESULTS: Mean age was 52 ± 12 years and 55% of the cases were younger than 55 years. Mean CA-IMT was 0.74 ± 0.19 mm and 48% had IMT values > 0.75 mm. Chronicty index was ≥5 in 55% of the cases. Chronicity index was higher in cases older than 55 years. Age and CA-IMT were significantly correlated with chronic vascular changes and chronicity index. CA-IMT > 0.75 mm had a 46% sensitivity and 90% specificity to predict nephrosclerosis. Positive and negative predictive values were 85% and 57%, respectively. CONCLUSION: Aging leads to detrimental changes in every part of the vasculature of the human body. CA-IMT is correlated with the level of nephrosclerosis. Measurement of CA-IMT reflects nephrosclerosis especially in older patients.