Key result
Higher CIMT linked to ~16% higher mortality risk per 0.1 mm in hemodialysis patients.
Why the study?
Chronic kidney disease patients on hemodialysis have high cardiovascular mortality, and the prognostic significance of carotid intima-media thickness in this population is unclear.
Cohort (n=138)
Single-blind
No
Hazard Ratio: 1.16 (95% CI 0.15–9.09)
May refine mortality prediction in hemodialysis; extends prior observational data but requires validation before clinical adoption.
BACKGROUND: Chronic kidney disease (CKD) patients on hemodialysis are highly prone to cardiovascular disease, which accounts for roughly half of the mortality in these patients. Atherosclerosis begins many years before the development of clinical manifestations. Measurement of carotid intima-media thickness (CIMT) is a noninvasive procedure to detect early atherosclerotic changes. AIMS: The aim of the study was to evaluate the correlation between CIMT and cardiovascular risk factors and to investigate its prognostic significance in CKD patients on hemodialysis. MATERIALS AND METHODS: This was a prospective study carried out over a period of 18 months. Total 88 patients on hemodialysis and 50 healthy controls were enrolled in the study. Biochemical assay and CIMT was assessed using the high resolution 7.5 MHz sonography technique in all subjects. RESULTS: Significant positive correlation was found with age, blood urea, serum creatinine, serum triglyceride, low-density lipoprotein, serum phosphorus, serum calcium-phosphorus product, serum uric acid, 24 h urine protein, systolic blood pressure, diastolic blood pressure, and body mass index. Negative correlation was found with estimated glomerular filtration rate. Adjusted hazards ratios of all cause and cardiovascular mortality for an increase of 0.1 mm in CIMT was 1.16 (95% confidence interval 0.15-9.09). Patients with CIMT value <0.97 mm had a renal survival rate of 73.4% while patients with value >0.97 mm had a renal survival rate of 16.5%. CONCLUSION: Uremia is an additive risk factors in those subjects who have raised CIMT despite of traditional cardiovascular risk factors.
No takes yet. Share an insight, caveat, or question.
Patel et al. (2015) conducted a cohort in Chronic kidney disease (CKD) on hemodialysis (n=138). Carotid intima-media thickness (CIMT) vs. Lower CIMT was evaluated on All-cause and cardiovascular mortality associated with a 0.1 mm increase in CIMT (HR 1.16, 95% CI 0.15-9.09). Each 0.1 mm increase in carotid intima-media thickness was associated with a 16% higher risk of all-cause and cardiovascular mortality (HR 1.16) in patients with chronic kidney disease on hemodialysis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: