Carotid atherosclerosis and cardiovascular risk factors in hemodialysis and peritoneal dialysis patients.
BACKGROUND
Cardiovascular diseases are important factors in mortality and morbidity of dialysis patients. Cardiovascular risk assessment is important in order to arrange the treatment strategies. The aim of the study was to investigate the relationship between carotid atherosclerosis and various CVD risk factors in dialysis patients.


METHODS
22 HD and 54 PD patients were included in the study. Carotid artery intima media thickness (IMT) and plaque score (PS) were obtained by B-mode ultrasonography for each participant. Uric acid, albumin, bilirubin, lipid profile, apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], high-sensitivity CRP (hs-CRP), homocysteine (Hcy), vitamin A, vitamin E, sialic acid (SA) and thiobarbituric acid-reactive substances (TBARS) were determined. The differences of the cardiovascular risk factors between the patients according to the treatment modality and the comparison of the risk factors as indicators of IMT and PS were investigated.


RESULTS
There was no significant difference in IMT and PS between the two groups. SA, TBARS, hs-CRP, total, HDL- and LDL-cholesterol, white blood cell (WBC) and erythrocyte sedimentation rate (ESR) levels were significantly higher; albumin levels were significantly lower in PD group. In multiple regression analysis, only bilirubin for IMT and SA for PS were independent predictors.


CONCLUSIONS
SA can be a superior marker to hs-CRP in PD patients; however, hs-CRP seems to be a more valuable marker than SA in HD patients according to the correlation analysis. This study provides information and opportunity for comparison of relatively new cardiovascular risk markers in hemodialysis and peritoneal dialysis patients using carotid atherosclerosis as an objective assessment criterion.
Yilmaz
Fatma Meriç
FM
Clinical Biochemistry Laboratory, Ministry of Health, Ankara 06340, Turkey.
Akay
Hatice
H
Duranay
Murat
M
Yilmaz
Gülsen
G
Oztekin
Pelin Seher
PS
Koşar
Uğur
U
Tekeli
Nurçin
N
Altay
Mustafa
M
Parpucu
Hülya
H
Yücel
Doğan
D
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019158:N-Acetylneuraminic Acid / Q000097:blood; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D017539:Tunica Intima / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014463:Ultrasonography
D017392:Thiobarbituric Acid Reactive Substances; D006710:Homocysteine; D002097:C-Reactive Protein; D019158:N-Acetylneuraminic Acid