Carotid ultrasonographic parameters as markers of atherogenesis and mortality rate in patients on hemodialysis.
OBJECTIVE
Vascular endothelium plays an important role in atherogenesis. The aim of this study was to estimate the correlation of endothelium malfunction and arteriosclerosis in patients on hemodialysis.


METHODS
The investigation was designed as a clinical, non-randomized, five-year study in the "Kragujevac" Clinical Center and included 146 patients. We evaluated demographic characteristics, smoking, duration of dialysis, existence of tissue calcification and duplex ultrasound parameters of the carotid artery. All lethal outcomes, including the cause and time of death were recorded.


RESULTS
The cumulative survival rate was 57.5%. Survival was short in patients with wider lumen diameter of the carotid arteries. Carotid artery lumen diameter in men was wider than in women. The area cross section was closely correlated with intima media thickness (r = 0.913; p < 0.0001), as well as with the lumen diameter of the carotid arteries (r = 0.527;p < 0.0001). Carotid artery lumen diameter was negatively associated with serum cholesterol (r = -0.278; p = 0.019), while serum triglycerides correlated negatively with the cross section of intima media (r = -0.261; p = 0.028). Positive correlations were found between the serum total protein level and carotid artery lumen diameter (r = 0.235; p = 0.047), cross section intima media (r = 0.269; p = 0.022) and cholesterol (r = 0.248; p = 0.037). Time on dialysis showed a negative correlation with carotid artery cross section (r = -0.241; p = 0.04), while age was positively correlated with intima media (r = 0.295; p = 0.013), lumen diameter (r = 0.296; p = 0.012) and intima media cross section (r = 0.347; p = 0.003). Regression analysis pointed to predictive importance of carotid artery lumen diameter for survival (Beta = 0.437; p = 0.011) of the examined patients. The cumulative rate of survival was 57%.


CONCLUSIONS
In our study patient age correlated positively with all parameters of arteriosclerosis. The average duration of dialysis was negatively associated with carotid artery diameter, which was significantly higher in males. Regression correlation analyses indicated that the survival rate of the patients on hemodialysis was lower if the carotid artery diameter was larger.
University of Pristina, Faculty of Medicine, Internal Clinic, Pristina/Kosovska Mitrovica, Serbia. radsto@ptt.rs
Radojica
R
Stolić
Goran
G
Trajković
Aleksandar
A
Jovanović
Dragica
D
Stolić
Vladan
V
Perić
Sasa
S
Sovtić
Gordana
G
Subarić-Gorgieva
D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D014280:Triglycerides; D002784:Cholesterol