title: Risk factors for aortic atherosclerosis determined by transesophageal echocardiography in patients with CRF.
abstract: BACKGROUND
  The significance of various risk factors for cardiovascular disease (CVD) in the pathogenesis of atherosclerosis in patients with chronic renal failure (CRF) is, to a great deal, unresolved. The high risk for CVD in patients with CRF may be caused by the high prevalence of recognized risk factors for CVD or by factors characteristic of CRF in these patients. In this prospective cross-sectional study, we examined risk factors for thoracic aortic atherosclerosis in a population of patients with CRF consisting of predialysis and dialysis patients, as well as renal transplant recipients.
  
  
  METHODS
  Of 118 patients, 52 patients had moderate to severe predialysis CRF, 32 patients were on dialysis treatment, and 34 patients were renal transplant recipients. Mean age was 52 +/- 12 years, and 35 patients (30%) had diabetes. Multiplane transesophageal echocardiography (TEE) was performed using local anesthesia.
  
  
  RESULTS
  Large aortic plaques (LAPs; > or = 3.0 mm in diameter) were found in 39 patients (33%). In univariate analysis, age, duration of hypertension, pulse pressure, low diastolic blood pressure, elevated fibrinogen level, C-reactive protein level, total cholesterol level, low-density lipoprotein cholesterol level, and duration of dialysis or a functioning renal transplant were significantly associated (P < 0.05) with LAP. In multivariate analysis, age, duration of hypertension, and total cholesterol level were associated with LAP.
  
  
  CONCLUSIONS
  Results of the present TEE study suggest that in addition to duration of hypertension and renal disease, hypercholesterolemia has a role in the pathogenesis of atherosclerosis in patients with CRF.
authors.affiliation: Department of Internal Medicine, Tampere University Hospital, Tampere, Finland. yrjo.leskinen@uta.fi
authors.forename: Yrjö
authors.initials: Y
authors.lastname: Leskinen
authors.forename: Kaj
authors.initials: K
authors.lastname: Groundstroem
authors.forename: Vesa
authors.initials: V
authors.lastname: Virtanen
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Heikki
authors.initials: H
authors.lastname: Saha
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017548:Echocardiography, Transesophageal; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology