Screening for carotid artery stenosis and renal artery stenosis in patients undergoing tunneled cuffed hemodialysis catheter placement.
In this study, we noted the common risk factors with atherosclerosis and chronic renal disease. We, therefore, hypothesized that the placement of a dialysis catheter would be a useful marker in identifying populations at increased risk of vascular disease (carotid, renal, and aortic). To further explore this issue, we examined the results of duplex scanning of the carotid arteries and aortorenal arteries in patients undergoing dialysis catheter placement. Over 49 months, each of the 123 patients who underwent permanent tunneled dialysis catheter placement received a carotid duplex study. Twelve patients (9.8%) had ≥ 60% stenosis and 8 patients (6.5%) had 70% to 99% stenosis. Furthermore, 109 patients who underwent a aortorenal artery duplex study were also analyzed. The study population demonstrated a prevalence rate of 3.7% for abdominal aorta aneurysm (AAA) and 4.6% for renal artery stenosis (RAS). Based upon these data, we suggest performing routine carotid duplex scans in patients who will also receive dialysis catheter placement. However, the data did not support routine screening of AAA or RAS.
Department of Surgery, Division of Vascular Surgery, Lutheran Medical Center, Brooklyn, NY 11219, USA.
Roy
R
Lin
Anil
A
Hingorani
Natalie
N
Marks
Enrico
E
Ascher
Robert
R
Jimenez
Ed
E
Aboian
Thom
T
McIntyre
Theresa
T
Jacob
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D015897:Comorbidity; D004867:Equipment Design; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex