Key result
Carotid plaque linked to ~14-fold higher odds of carotid calcification in incident hemodialysis patients.
Why the study?
The relationship between carotid artery calcification and carotid atherosclerosis in patients with end-stage renal disease at hemodialysis initiation remained unclear.
Cross-Sectional (n=135)
Answers are grounded in this paper and cite their sources.
In patients with ESRD starting hemodialysis, carotid artery calcification and atherosclerosis are highly prevalent and strongly associated with each other, despite having different traditional risk factors.
AIMS: Vascular calcification and atherosclerosis frequently develop in end-stage renal disease (ESRD). Although several reports have investigated both carotid artery calcification (CAAC) and carotid atherosclerosis in ESRD patients, the relationship between the two vascular conditions has remained unclear. The aim of this study was to assess the prevalence of CAAC and carotid artery plaque (CAP) in patients with ESRD and to investigate potential factors contributing to the development of CAAC and CAP. MATERIAL AND METHOD: This cross-sectional study assessed CAAC and CAP using multidetector computed tomography and high-resolution B-mode ultrasonography, respectively, in 135 patients with ESRD at the start of hemodialysis. The prevalence of CAAC and CAP was examined. The risk factors associated with CAAC and CAP were also evaluated using a logistic regression model. RESULTS: CAAC and CAP were found in 71% and 65%, of the patients, respectively. A logistic regression analysis adjusted for age and gender showed that CAAC was significantly associated with age, hypertension, dyslipidemia, serum albumin, calcium-phosphorus product, proteinuria and CAP. In contrast, in the same analysis, CAP was significantly correlated with age, male gender, diabetes, intact parathyroid hormone, proteinuria and CAAC. In the multivariate analysis, CAAC was independently associated with age, hypertension, and calcium-phosphorus product. Male gender was identified as an independent determinant for CAP. Furthermore, CAP remained as an independent risk factor of CAAC (odds ratio (OR): 13.89; 95% confidence interval (CI): 4.08-47.29), and CAAC also showed a high OR for having CAP (OR: 11.74; 95% CI: 4.12-33.51). CONCLUSION: Both CAAC and CAP were associated with traditional and/or non-traditional risk factors. The risk factors of CAAC were different from those of CAP. CAAC or CAP was identified to be an independent risk factor for each other with a high OR, thus suggesting a strong relationship between carotid calcification and atherosclerosis.
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Sumida et al. (2010) conducted a cross-sectional in End-stage renal disease (ESRD) (n=135). Carotid artery plaque (CAP) vs. Absence of CAP was evaluated on Presence of carotid artery calcification (CAAC) (OR 13.89, 95% CI 4.08-47.29). Carotid artery plaque was strongly associated with carotid artery calcification (OR 13.89; 95% CI 4.08-47.29) in patients with end-stage renal disease at the initiation of hemodialysis.
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