Prevalence of Subclinical Atherosclerosis and Geometric Left Ventricular Variations in Adult Patients with Chronic Kidney Disease

International Journal of Medicine and Medical Sciences | Vol. 15, No. 10, October 2025 | pp. 73–80

DOI: 10.46882/2025/IJMMS/150073

Original Research Article

Prevalence of Subclinical Atherosclerosis and Geometric Left Ventricular Variations in Adult Patients with Chronic Kidney Disease

Chidi O. Okafor¹, Amina J. Hassan², Samuel K. Appiah¹*

¹Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

²Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.

Abstract:

Chronic kidney disease (CKD) accelerates vascular remodeling, increasing the risks of early atherosclerosis and structural uremic cardiomyopathy. This cross-sectional cardiovascular study evaluated the prevalence of subclinical atherosclerosis and left ventricular (LV) geometric variations among non-dialysis adult patients with CKD. We evaluated 150 patients with confirmed stage 3 or 4 CKD (eGFR between 15 and 59 mL/min/1.73m²). High-resolution B-mode ultrasonography measured carotid intima-media thickness (CIMT) to identify subclinical atherosclerosis (CIMT ≥ 0.90 mm), while echocardiography quantified left ventricular mass index (LVMI) and relative wall thickness (RWT) to define structural geometry. The mean eGFR of the cohort was 34.8 ± 6.2 mL/min/1.73m². The overall prevalence of subclinical atherosclerosis was found to be 54.7% (82/150), and echocardiographic LVH was confirmed in 62.0% (93/150) of the participants. Geometric pattern distribution analysis revealed that concentric hypertrophy was the most common abnormal pattern (34.0%), followed by eccentric hypertrophy (18.0%) and concentric remodeling (10.0%), leaving only 38.0% with normal geometry. Linear regression analysis showed a significant positive correlation between increased CIMT and elevated LVMI (r = 0.54, p < 0.001). Multivariate logistic regression demonstrated that an eGFR < 30 mL/min/1.73m² (OR = 3.6, 95% CI = 1.8–7.2, p < 0.001) and poor blood pressure control (OR = 2.8, p < 0.01) were independent predictors of concentric hypertrophy. A high burden of structural cardiovascular remodeling exists among patients with advanced CKD, highlighting the importance of early cardioprotective interventions prior to reaching end-stage renal disease.

Keywords: Chronic Kidney Disease, Subclinical Atherosclerosis, Left Ventricular Hypertrophy, Echocardiography, Carotid Intima-Media Thickness, Cardiovascular Risk

Manuscript Timeline: Received: July 12, 2025; Revised: August 20, 2025; Accepted: September 10, 2025; Published: October 14, 2025.

Citation: Okafor CO, Hassan AJ, Appiah SK. Prevalence of Subclinical Atherosclerosis and Geometric Left Ventricular Variations in Adult Patients with Chronic Kidney Disease. International Journal of Medicine and Medical Sciences, 2025, 15(10): 73–80. DOI: 10.46882/2025/IJMMS/150073

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