title: Dynamic changes of carotid artery intima-media thickness and mortality in hemodialysis patients.
abstract: BACKGROUND
  Intima-media thickness (IMT) of the carotid artery is a widely accepted parameter for detection and quantification of atherosclerosis. The aim of the study was the evaluation of the impact of changes of IMT on the mortality of patients on hemodialysis.
  
  
  METHODS
  The study was organized as a prospective and observational one. Intima-media thickness was determined by ultrasound in 194 patients who were evaluated every year during a three-year period. We analyzed the mortality rate of patients on hemodialysis in relation to their biochemical parameters, demographic and anthropometric characteristics, type of dialysis, smoking habits and statin therapy.
  
  
  RESULTS
  Female gender and hemodiafiltration emerged as good predictors of long-term survival. Baseline IMT values were significantly lower than those at the end of the second (p <0.001) and third years of the study (p <0.001). The baseline values positively correlated with uric acid levels (p =0.027) and body mass index (p =0.024), while at the end of the second year, IMT positively correlated with LDL-cholesterol (p =0.037) and triglyceride levels (p =0.018) and body mass index (p =0.045). Patients on hemodiafiltration had significantly higher values for erythrocytes (p =0.047), hemoglobin (p =0.005), creatinine (p =0.048), Kt/V (p =0.026), albumin (p =0.012), LDL-cholesterol (p <0.001), body mass index (p <0.001),and lower IMT values at the end of the first year (p =0.039), compared to patients on bicarbonate hemodialysis. Predictors of death were the duration of hemodialysis (p <0.001), and IMT at the end of the first (p =0.008) and second years of the study (p =0.005).
  
  
  CONCLUSIONS
  Dynamic changes of IMT of the carotid arteries during the first two years were found in our study to be predictors of mortality in patients on hemodialysis. Hippokratia 2015; 19 (2):158-163.
authors.affiliation: Clinic of Nephrology and Urology, Medical faculty, University of Kragujevac, Kragujevac, Serbia.
authors.forename: R
authors.initials: R
authors.lastname: Stolic
authors.affiliation: Institute of Medical Statistics and Informatics, University of Kragujevac, Kragujevac, Serbia.
authors.forename: A
authors.initials: A
authors.lastname: Ilic
authors.affiliation: Internal Medicine Department, Medical faculty, University of Kragujevac, Kragujevac, Serbia.
authors.forename: A
authors.initials: A
authors.lastname: Jovanovic
authors.affiliation: Department of Orthopedics, Medical faculty, University of Kragujevac, Kragujevac, Serbia.
authors.forename: R
authors.initials: R
authors.lastname: Grbic
authors.affiliation: Children's Hospital, Faculty of Medicine Pristina/Kosovska Mitrovica, University of Pristina, Serbia.
authors.forename: D
authors.initials: D
authors.lastname: Odalovic
authors.affiliation: Internal Medicine Department, Medical faculty, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Lj
authors.initials: Lj
authors.lastname: Smilic
authors.affiliation: Internal Medicine Department, Medical faculty, University of Kragujevac, Kragujevac, Serbia.
authors.forename: S
authors.initials: S
authors.lastname: Lazic
authors.affiliation: Internal Medicine Department, Medical faculty, University of Kragujevac, Kragujevac, Serbia.
authors.forename: B
authors.initials: B
authors.lastname: Krdzic
authors.affiliation: Department of Radiology and Oncology, Clinical Center Kragujevac, Serbia.
authors.forename: J
authors.initials: J
authors.lastname: Nedovic
keywords: Dynamic changes; atherogenesis; carotid intima media; hemodialysis; mortality