Carotid intima media thickness and aortic calcification index closely relate to cerebro- and cardiovascular disorders in hemodialysis patients.
OBJECTIVE
Atherosclerosis can be evaluated by carotid intima media thickness (IMT), the aortic calcification index (ACI), and pulse wave velocity (PWV). We investigated which test was most closely related to cerebro- and cardiovascular disorders (CCVD) in hemodialysis patients.


METHODS
Maximum IMT (max-IMT), ACI, and PWV were examined in 110 hemodialysis patients, using carotid ultrasonography, abdominal CT and a blood pressure pulse wave instrument, respectively. Blood hemoglobin A1c (HbA1c), serum total cholesterol, high density lipoprotein cholesterol, triglyceride, total protein, albumin, high sensitivity C reactive protein (hs-CRP), and tumor necrosis factor alpha were measured. The patients were divided into two groups; with and without CCVD and the degree of atherosclerosis was evaluated in each group.


RESULTS
Compared to the CCVD (-) group, the CCVD (+) group showed significantly higher percentages of males and diabetic patients, higher levels of HbA1c (5.14 vs 4.83%) and hs-CRP (0.320 vs 0.167 mg/dL), an older age group (64.5 vs 57.5 years), a greater max-IMT (2.05 vs 1.19 mm), and a higher ACI (71.8 vs 41.0%); and significantly lower diastolic blood pressure (82.8 vs 89.2 mmHg). Multiple logistic regression analysis showed that the factors influencing the development of CCVD were age (odds ratio: 1.092), ACI (odds ratio: 1.025), and max-IMT (odds ratio: 2.006). However, PWV did not significantly relate to CCVD.


CONCLUSIONS
In hemodialysis patients, the ACI and max-IMT were significantly associated with CCVD, but the association of PWV was weak. A prospective cohort study is warranted to determine the risk factors for CCVD in hemodialysis patients.
Tsushima
Megumi
M
Oyokyo Kidney Research Institute, Hirosaki University School of Medicine, Hirosaki, Japan. staff@oyokyo.jp
Terayama
Yuriko
Y
Momose
Akishi
A
Funyu
Tomihisa
T
Ohyama
Chikara
C
Hada
Ryukichi
R
D017677:Age Distribution; D001018:Aortic Diseases / Q000175:diagnosis / Q000503:physiopathology; D001783:Blood Flow Velocity; D002114:Calcinosis / Q000175:diagnosis / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D015984:Causality; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D051437:Renal Insufficiency / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors; D017678:Sex Distribution; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography