Intima-media thickness of carotid artery predicts cardiovascular mortality in hemodialysis patients.

Abstract

BACKGROUND:

Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD). Previous studies showed that patients with ESRD had increased intima-media thickness of the carotid artery (CA-IMT). In the present study, we examined whether CA-IMT would predict cardiovascular mortality in patients with ESRD.

METHODS:

The cohort consisted of 438 patients with ESRD treated with hemodialysis. CA-IMT was measured by high-resolution B-mode ultrasonography.

RESULTS:

During the follow-up period of 30 months, 82 deaths, including 44 cardiovascular fatal events, occurred. Compared with those with CA-IMT less than 1.0 mm, those with moderately increased CA-IMT (1.0 to 2.0 mm) and those with severely increased CA-IMT (>or=2.0 mm) showed a significantly greater risk for death from cardiovascular causes; odds ratios were 3.17 (95% confidence interval [CI], 1.41 to 7.17; P = 0.005) and 10.20 (95% CI, 3.67 to 28.3; P < 0.0001), respectively, in a multivariate Cox analysis including age, sex, duration of hemodialysis therapy, presence of diabetes mellitus, blood pressure, body mass index, and high-density lipoprotein and non-high-density lipoprotein cholesterol levels as covariates. Conversely, CA-IMT was not significantly associated with noncardiovascular mortality.

CONCLUSION:

These results indicate that increased CA-IMT is an independent predictor of cardiovascular mortality in the hemodialysis population.

• Authors: Yoshiki Nishizawa, Tetsuo Shoji, Kiyoshi Maekawa, Kyoko Nagasue, Senji Okuno, Masao Kim, Masanori Emoto, Eiji Ishimura, Tatsuya Nakatani, Takami Miki, Masaaki Inaba
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 41 Issue 3 Suppl 1 Pg. S76-9 (Mar 2003) ISSN: 1523-6838 [Electronic] United States
• PMID: 12612958 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Cardiovascular Diseases (etiology, mortality)
• Carotid Arteries (diagnostic imaging, pathology)
• Cohort Studies
• Female
• Forecasting (methods)
• Humans
• Kidney Failure, Chronic (mortality, therapy)
• Male
• Middle Aged
• Multivariate Analysis
• Predictive Value of Tests
• Renal Dialysis (methods, mortality)
• Sex Distribution
• Survival Rate
• Tunica Intima (diagnostic imaging, pathology)
• Tunica Media (diagnostic imaging, pathology)
• Ultrasonography (methods, statistics & numerical data)