title: Impact of Carotid Intima-Media Thickness on Long-term Outcome in Hemodialysis Patients.
abstract: BACKGROUND
  Chronic kidney disease (CKD) patients on hemodialysis are highly prone to cardiovascular disease, which accounts for roughly half of the mortality in these patients. Atherosclerosis begins many years before the development of clinical manifestations. Measurement of carotid intima-media thickness (CIMT) is a noninvasive procedure to detect early atherosclerotic changes.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the correlation between CIMT and cardiovascular risk factors and to investigate its prognostic significance in CKD patients on hemodialysis.
  
  
  METHODS
  This was a prospective study carried out over a period of 18 months. Total 88 patients on hemodialysis and 50 healthy controls were enrolled in the study. Biochemical assay and CIMT was assessed using the high resolution 7.5 MHz sonography technique in all subjects.
  
  
  RESULTS
  Significant positive correlation was found with age, blood urea, serum creatinine, serum triglyceride, low-density lipoprotein, serum phosphorus, serum calcium-phosphorus product, serum uric acid, 24 h urine protein, systolic blood pressure, diastolic blood pressure, and body mass index. Negative correlation was found with estimated glomerular filtration rate. Adjusted hazards ratios of all cause and cardiovascular mortality for an increase of 0.1 mm in CIMT was 1.16 (95% confidence interval 0.15-9.09). Patients with CIMT value <0.97 mm had a renal survival rate of 73.4% while patients with value >0.97 mm had a renal survival rate of 16.5%.
  
  
  CONCLUSIONS
  Uremia is an additive risk factors in those subjects who have raised CIMT despite of traditional cardiovascular risk factors.
authors.affiliation: Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Munna Lal
authors.initials: ML
authors.lastname: Patel
authors.affiliation: Department of Geriatric ICU, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.lastname: Radheyshyam
authors.affiliation: Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Verma
authors.affiliation: Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Rekha
authors.initials: R
authors.lastname: Sachan
authors.affiliation: Department of Statistics, Indian Toxicology and Research Centre, Lucknow, Uttar Pradesh, India.
authors.forename: Ritul
authors.initials: R
authors.lastname: Kamal
keywords: Carotid intima-media thickness; Hemodialysis; Outcome