title: Prevalence and correlates of vascular disease at ultrasound examination in patients on hemodialysis.
abstract: BACKGROUND
  Patients on hemodialysis present an increased risk of cardiovascular death. Intimal media thickness (IMT) and presence of arterial calcifications are well-known risk factors for cardiovascular death in hemodialysis patients.
  
  
  OBJECTIVE
  To assess the prevalence of IMT and arterial calcifications in HD patients and to correlate image findings with clinical and laboratory data.
  
  
  METHODS
  Cross-sectional study involving 75 patients on dialysis for >12 months. Patients underwent B-mode ultrasound scan (US) for determination of IMT of the distal third of the common carotid arteries. Arterial calcifications were assessed by US of carotids, femoral and tibial arteries, and labeled positive if calcification was found in any arterial site.
  
  
  RESULTS
  Patients were 52±13 years old, 57% were males and 16% were diabetics. IMT > 0.9 mm was found in 57% of cases and arterial calcifications at US in 48%. Aging (decades) and smoking were associated with both increased IMT (adjusted odds ratio [aOR] = 3.4, p < 0.001; aOR = 4.4, p = 0.045, respectively) and presence of vascular calcifications (aOR = 3.0, p < 0.001; aOR = 6.8, p = 0.011, respectively). High intact parathyroid hormone levels (per each 100 pg/ml) were significantly associated with increased IMT (aOR = 1.7, p = 0.021), but not with vascular calcification. In contrast, Diabetes and time on dialysis (years) were significant determinants for calcifications at US (aOR = 15.0, p = 0.009; aOR = 1.39, p = 0.020), but not for increased IMT.
  
  
  CONCLUSIONS
  Increased IMT and calcifications at US are common findings in hemodialysis patients. Aging and smoking are consistent determinants for both image alterations. Parathyroid hormone elevation is associated with increased IMT. Diabetes and time on dialysis substantially increase the risk for arterial calcification.
authors.affiliation: Clinefron Clínica de Doenças Renais, Brazil.
authors.forename: Sebastião Baptista
authors.initials: SB
authors.lastname: Miguel
authors.forename: Jair Baptista
authors.initials: JB
authors.lastname: Miguel
authors.forename: Luis Guilhermo
authors.initials: LG
authors.lastname: Velarde
authors.forename: Elisa de Albuquerque
authors.initials: Ede A
authors.lastname: Sampaio
authors.forename: Jorge Paulo Strogoff de
authors.initials: JP
authors.lastname: Matos
authors.forename: Jocemir Ronaldo
authors.initials: JR
authors.lastname: Lugon
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D048909:Diabetes Complications; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone