Intima-media thickness of carotid artery predicts cardiovascular mortality in hemodialysis patients.
BACKGROUND
Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD). Previous studies showed that patients with ESRD had increased intima-media thickness of the carotid artery (CA-IMT). In the present study, we examined whether CA-IMT would predict cardiovascular mortality in patients with ESRD.


METHODS
The cohort consisted of 438 patients with ESRD treated with hemodialysis. CA-IMT was measured by high-resolution B-mode ultrasonography.


RESULTS
During the follow-up period of 30 months, 82 deaths, including 44 cardiovascular fatal events, occurred. Compared with those with CA-IMT less than 1.0 mm, those with moderately increased CA-IMT (1.0 to 2.0 mm) and those with severely increased CA-IMT (>or=2.0 mm) showed a significantly greater risk for death from cardiovascular causes; odds ratios were 3.17 (95% confidence interval [CI], 1.41 to 7.17; P = 0.005) and 10.20 (95% CI, 3.67 to 28.3; P < 0.0001), respectively, in a multivariate Cox analysis including age, sex, duration of hemodialysis therapy, presence of diabetes mellitus, blood pressure, body mass index, and high-density lipoprotein and non-high-density lipoprotein cholesterol levels as covariates. Conversely, CA-IMT was not significantly associated with noncardiovascular mortality.


CONCLUSIONS
These results indicate that increased CA-IMT is an independent predictor of cardiovascular mortality in the hemodialysis population.
Nishizawa
Yoshiki
Y
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Japan. yynisizawa@med.osaka-cu.ac.jp
Shoji
Tetsuo
T
Maekawa
Kiyoshi
K
Nagasue
Kyoko
K
Okuno
Senji
S
Kim
Masao
M
Emoto
Masanori
M
Ishimura
Eiji
E
Nakatani
Tatsuya
T
Miki
Takami
T
Inaba
Masaaki
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005544:Forecasting / Q000379:methods*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000379:methods / Q000401:mortality*; D017678:Sex Distribution; D015996:Survival Rate; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data