Correlation of Carotid Intima-Media Thickness With Clinical and Biochemical Parameters in Hemodialysis Patients: A Cross-Sectional Study

Background: Cardiovascular disease remains the leading cause of mortality in patients with end-stage renal disease (ESRD), and carotid intima-media thickness (CIMT) has emerged as a non-invasive surrogate marker for subclinical atherosclerosis. In patients undergoing hemodialysis, chronic inflammation, metabolic abnormalities, and traditional risk factors may accelerate vascular changes. Early identification of such vascular alterations can guide timely interventions to reduce cardiovascular morbidity and mortality in this high-risk group. Objective: To evaluate carotid intima-media thickness in patients on maintenance hemodialysis and investigate its association with clinical and biochemical parameters. Methods: This cross-sectional study was conducted over six months at the Department of Nephrology, Combined Military Hospital, Rawalpindi. A total of 145 adult patients with ESRD undergoing hemodialysis for at least three months were enrolled. Patients with acute infections, inflammatory conditions, recent carotid surgery, or incomplete data were excluded. Demographic, clinical, and biochemical data were collected through structured questionnaires and laboratory assessments. CIMT was measured bilaterally at three predefined carotid artery sites using a GE Voluson E6 ultrasound machine. Data analysis was performed using SPSS version 20, with significance set at p < 0.05. Results: Participants had a mean age of 46.3 ± 12.4 years, with 58.6% males. Hypertension (81.3%), lipid disorders (90.3%), and diabetes mellitus (52.4%) were prevalent. Elevated serum creatinine (6.8 ± 2.1 mg/dL), triglycerides (158 ± 82 mg/dL), and homocysteine (39.5 ± 28.4 μmol/L) were observed. Mean CIMT was 0.80 ± 0.15 mm (right) and 0.79 ± 0.14 mm (left), with increased CIMT (≥0.8 mm) seen in 72.4% and 69.0% of patients, respectively. CIMT was significantly correlated with age, CKD duration, dialysis time, hypertension, diabetes, lipid levels, creatinine, triglycerides, and homocysteine. Conclusion: There is a high burden of subclinical atherosclerosis among hemodialysis patients, as indicated by increased CIMT and its strong associations with modifiable and disease-specific risk factors. Addressing hypertension, diabetes, and dyslipidemia may be critical to reducing cardiovascular complications in this population.