Intima-Media Thickness of the Carotid Artery and Its Correlation Factors in Maintenance Hemodialysis Patients: A Cross-Sectional Study

Abstract

Background: To investigate the relationship between the intima-media thickness of the carotid artery (CA-IMT) and its major risk factors in maintenance hemodialysis (MHD) patients. Methods: Seventy-five MHD patients and 30 healthy volunteers were enrolled. The MHD patients were divided into 3 subgroups according to their CA-IMT value. Results: CA-IMT values in the MHD group were significantly higher than those in the control group. The differences in age, systolic blood pressure (SBP), and levels of serum albumin, prealbumin, cholesterol and serum phosphate between the increased IMT group and the normal IMT group were significant. SBP and serum phosphate levels were also greater in the abnormal IMT group than those in the normal IMT group. Significant relationships were found between CA-IMT and age, SBP, and serum levels of phosphate, albumin and prealbumin. In multiple regression analysis, a high serum phosphate level, low serum prealbumin level and high SBP were significant independent risk factors of increased CA-IMT. Conclusions: CA-IMT was increased dramatically in MHD patients. A high serum phosphate level, low serum prealbumin level and high SBP may be associated with advanced arteriosclerosis.

Hemodialysis‐induced cardiovascular disease

“…Both atherosclerosis and arteriosclerosis are predominant in uremic patients . Atherosclerosis is characterized by plaque formation in medium‐sized arteries while arteriosclerosis is characterized by diffuse calcification and dilation of the medial layer of the aorta and major branches.…”

“…Both atherosclerosis and arteriosclerosis are predominant in uremic patients. 18,19 Atherosclerosis is characterized by plaque formation in medium-sized arteries while arteriosclerosis is characterized by diffuse calcification and dilation of the medial layer of the aorta and major branches. In uremic patients, hyperparathyroidism secondary to derangements in calcium, phosphate, fibroblast growth factor 23, and vitamin D homeostasis in CKD patients leads to thickening of blood vessels.…”

Elevated serum retinol-binding protein 4 concentrations are associated with chronic kidney disease but not with the higher carotid intima-media thickness in type 2 diabetic subjects

“…However, there has been reported that retinol/RBP4 ratio is strongly and independently associated with CIMT [31]. Transthyretin, which binds with RBP4 and prevents its glomerular filtration and catabolism in the kidney, has been showed to be significantly decreased in patients with CKD [32], and be a significantly independent risk factor of increased CIMT in maintenance hemodialysis patients [33]. Besides, the RBP4 isoforms including apo-RBP4, RBP4-L and RBP4-LL are all elevated in patients with CKD [32].…”

Effect of Sevelamer Hydrochloride Exposure on Carotid Intima Media Thickness in Hemodialysis Patients

“…The association between vascular calcification and cardiovascular events has been well-established in non-CKD populations, and evidence of this association in the CKD population is accruing. A positive association between carotid IMT and coronary artery calcification has been demonstrated in HD patients [25]. …”