title: Advanced atherosclerosis in predialysis patients with chronic renal failure.
abstract: BACKGROUND
  Atherosclerosis is advanced in hemodialysis patients as shown by increased intima-media thickness of carotid arteries (CA-IMT), although it is not established whether the advanced atherosclerosis results from hemodialysis treatment or from chronic renal failure. The purpose of this study was to evaluate the effects of hemodialysis and renal failure on CA-IMT in patients with chronic renal failure.
  
  
  METHODS
  CA-IMT was measured by high-resolution B-mode ultrasonography in 110 patients with chronic renal failure before starting dialysis (CRF group), and compared with CA-IMT of 345 hemodialysis patients (HD group) and 302 healthy control subjects. They were all nondiabetic and the three groups were comparable in age and gender.
  
  
  RESULTS
  As compared with the healthy control subjects, the CRF and HD groups had greater CA-IMTs, whereas CA-IMTs of the CRF and HD groups were not statistically different. There was no significant correlation between duration of hemodialysis and CA-IMT in the HD group. Multiple regression analysis in the total subjects indicated that presence of renal failure, but not being treated with hemodialysis, was a significant factor associated with increased CA-IMT independent of age, gender, blood pressure, smoking, high-density lipoprotein (HDL) and non-HDL cholesterol levels.
  
  
  CONCLUSIONS
  These results demonstrate that thickening of arterial wall is present in patients with chronic renal failure before starting hemodialysis treatment, and support the concept that advanced atherosclerosis in hemodialysis patients is due not to hemodialysis treatment, but to renal failure and/or metabolic abnormalities secondary to renal failure.
authors.affiliation: Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Japan. t-shoji@med.osaka-cu.ac.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shoji
authors.forename: Masanori
authors.initials: M
authors.lastname: Emoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tabata
authors.forename: Eiji
authors.initials: E
authors.lastname: Kimoto
authors.forename: Kayo
authors.initials: K
authors.lastname: Shinohara
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maekawa
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kawagishi
authors.forename: Hideki
authors.initials: H
authors.lastname: Tahara
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
mesh_terms: D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000209:etiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D006435:Renal Dialysis; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography