Carotid hemodynamic parameters in hemodialysis patients.
BACKGROUND
Atherosclerotic vascular disease is a major cause of morbidity and mortality for patients with end-stage renal disease on maintenance hemodialysis. Early atherosclerotic changes of the arterial wall can be evaluated by intima-media thickness (IMT), presence and structure of plaques and parameters of vascular resistance. The aim of the present study has been to investigate the relationship between carotid IMT and pulsatility index (PI) or resistive index (RI) values in hemodialysis patients.


METHODS
We studied 36 hemodialysis patients (21 female, 15 male; median age 39.5 years, IQR 33.0-54.7 years) and 38 healthy volunteers (20 women, 18 men; median age 41.0 years IQR 32.5-53.5 years). All subjects underwent ultrasonography of common carotid artery, with determination of IMT, PI and RI.


RESULTS
Bilateral and mean carotid IMT were found to be significantly higher in hemodialysis patients than in the control group (P<0.0001). Right and left carotid artery RI values were determined to be lower in hemodialysis patients than in the control group (P=0.007 for both). Similarly, right and left carotid PI values were also determined significantly lower in the hemodialysis group (P=0.005 and P=0.004, respectively). There was a moderate negative correlation between the right carotid IMT and right PI (r=-0.258, P=0.026).


CONCLUSIONS
In contrast to previous studies in patients with diabetes, hypertension or cerebrovascular disease, PI and RI values decrease when IMT increases in hemodialysis patients. This finding may be a result of peripheral vasodilatation secondary to anemia in hemodialysis patients.
Karaman
Ozcan
O
Department of Internal Medicine, School of Medicine, Afyon Kocatepe University, 03200 Afyonkarahisar, Turkey.
Albayrak
Ramazan
R
Colbay
Mehmet
M
Yuksel
Seref
S
Uslan
Ihsan
I
Acarturk
Gursel
G
Saglam
Hayrettin
H
D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D006435:Renal Dialysis; D018709:Statistics, Nonparametric; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance