Key result
Hemodialysis patients with ischemic heart disease had significantly higher carotid intima-media thickness compared to those without the disease (0.85 mm vs 0.68 mm, p<0.01).
Cross-Sectional (n=40)
No
Absolute Event Rate: 0.85% vs 0.68%
p-value: p=<0.01
Carotid intima-media thickness is significantly increased in hemodialysis patients and correlates with traditional risk factors and the presence of ischemic heart disease, serving as a useful surrogate marker for cardiovascular risk.
CIMT may aid risk stratification in hemodialysis; leaves open incremental value and need for prospective validation.
Patients with chronic renal failure are prone to cardiovascular complications. The mechanisms and the assessment of the risk of cardiovascular diseases (CVD) in this population are of interest. The purpose of this study was to investigate the traditional and potential risk factors for the development of CVD and their contribution to ischemic heart disease (IHD) and variation in carotid intima media thickness (IMT) in hemodialyzed patients (HD). Twenty-one chronically HD patients and nineteen healthy volunteers were recruited. Studied parameters were intima-media thickness, body mass index (BMI), mean arterial blood pressure (MAP), hemoglobin, fibrinogen (Fbg), serum lipids, lipoprotein (a) [Lp(a)], total homocysteine (tHcy). Mean carotid IMT, tHcy, Fbg and Lp(a) were higher in HD patients compared to the control group. There were no differences in cholesterol (tCh) and triglycerides between these groups. Patients with ischemic heart disease were older and they had higher values of carotid IMT, tCh, triglycerides, Fbg and Lp(a). There were no differences in MAP, time on dialysis and tHcy between the two subgroups (with vs without IHD). Carotid IMT correlated positively with age (r = 0.68, p = 0.001), BMI (r = 0.50, p = 0.02), tCh (r = 0.58, p < 0.01), LDL- cholesterol (r = 0.55, p = 0.01) and Fbg (r = 0.57, p < 0.01) but not with tHcy or Lp(a) in the patients group. Carotid intima media thickness thus reflects the risk for ischemic heart disease in hemodialyzed patients. Elevated fibrinogen concentration and dyslipidemia influence arterial remodelling.
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Łebkowska et al. (2005) conducted a cross-sectional in End-stage renal disease on hemodialysis (n=40). Ischemic heart disease vs. Absence of ischemic heart disease was evaluated on Carotid intima-media thickness (p=<0.01). Hemodialysis patients with ischemic heart disease had significantly higher carotid intima-media thickness compared to those without the disease (0.85 mm vs 0.68 mm, p<0.01).
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