nontraditional cardiovascular biomarkers and estimation of cardiovascular risk in predialysis chronic kidney disease patients and their correlations with carotid intima media thickness

patients and methods this cross-sectional study included a total of 120 adult predialysis ckd patients. forty patients were allocated in each predialysis ckd group of stages 3, 4, and 5. serum ctnt and hs-crp, plasma nt-probnp, and single spot urine albumin creatinine ratio (acr) were measured. ultrasonographic examination of carotid artery was done with 7.5 mhz linear probe in b mode ultrasonography and carotid intima media thickness was measured. results mean values ± standard deviation of plasma nt-probnp (pg/ml), serum hs-crp (mg/l), spot urine acr (mg/g of creatinine), and cimt (mm) were 585.68 ± 514.84, 5.96 ± 2.52, 719.37 ± 411.36, and 0.78 ± 0.15, respectively in predialysis ckd patients (n = 120). serum ctnt level was high in 40% of predialysis ckd patients. among cardiovascular biomarkers, plasma nt-probnp had maximum strength of correlation (spearman rho correlation coefficient; r = 0.575 and p < 0.0001) with the carotid intima media thickness followed by serum ctnt (spearman rho correlation coefficient; r = 0.419 and p < 0.0001), spot urine albumin creatinine ratio (spearman rho correlation coefficient; r = 0.322 and p < 0.0001), and serum hs-crp (spearman rho correlation coefficient; r = 0.246 and p = 0.007). conclusions nontraditional cardiovascular biomarkers such as plasma nt-probnp, serum ctnt, serum hs-crp, and spot urine acr significantly correlate with cimt. these biomarkers can estimate the cardiovascular risk in a predialysis ckd population with expected high cardiac morbidity and mortality. background cardiovascular biomarkers such as n-terminal pro-b-type natriuretic peptide (nt-probnp), cardiac troponin t (ctnt), hs-crp (high sensitivity c-reactive protein), and albuminuria predict underlying heart disease in the general population as well as ckd patients. objectives we aimed to study the association of nt-probnp, ctnt, hs-crp, and spot urine albumin creatinine ratio with carotid intima media thickness (cimt) for cardiovascular risk estimation in predialysis ckd (chronic kidney disease) patients.