Obesity, Chronic Renal Failure and Carotid Intima-Medial Thickness

Obesity is positively associated with atherosclerosis, coronary and carotid artery calcification with high risk of co-morbidity and mortality. Carotid artery intimo-media thickness (CIMT) measurement is an early marker of vascular pathology and a reliable method for detection of early atherosclerosis and assessment of its advancement. It should be evaluated in every asymptomatic adult or hypertensive patient at moderate risk for cardiovascular disease. Carotid artery ultrasound scan is the method of choice and the results are reliable. CIMT values of more than 0.08 mm should be considered abnormal. Increased arterial stiffness is a hallmark of chronic kidney disease and is associated with adverse alterations in cardiac structure and function that predispose to an increased risk of cardiovascular death. Thus, identifying patients at high risk of cardiovascular disease with poor clinical outcome, allow for early prevention and reduction of mortality in these patients. Cardiovascular complications are the predominant cause of death in patients with chronic renal disease, particularly End stage renal disease (ESRD).