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Spatial inhomogeneity of common carotid artery intima-media is increased in dialysis patients.

Abstract

BACKGROUND

Structural abnormalities of the common carotid artery (CCA), as assessed by ultrasound techniques, are related to cardiovascular outcome in dialysis patients. An increased intima media thickness (IMT) of the CCA may both represent a reaction to a haemodynamic burden as well as atherosclerosis. With a new ultrasound technique CCA-IMT and IMT-inhomogeneity, a novel parameter of spatial variance of the IMT, were measured and related to traditional and non-traditional risk factors.

METHODS

In a cross-sectional study, we included 134 dialysis patients, aged 61+/-13 years (103 on haemodialysis, 31 on peritoneal dialysis) and 41 controls, aged 60+/-8 years. Age, sex, pulse pressure, diabetes, prevalent cardiovascular disease (CVD) and height were included in the basic multiregression analysis. Ultrasound examination of the CCA was performed. We also measured serum fetuin-A, high-sensitivity C-reactive protein (hsCRP), antibodies to oxidized low density lipoproteins (anti-oxLDL antibodies), calcium, phosphate, albumin and parathyroid hormone.

RESULTS

Compared with controls, dialysis patients had a greater CCA-IMT (670 microm vs 590+/-10 microm; P=0.002) and a greater CCA-IMT inhomogeneity (11.0 vs 8.1%; P=0.013). Dialysis patients with CVD had a greater CCA-IMT (734 microm vs 631 microm; P=0.001) and IMT-inhomogeneity (13.2 vs 9.7; P=0.008) compared with patients without CVD. IMT-inhomogeneity strongly correlated with IMT (R=0.65, P<0.0001). In multiregression analysis, serum fetuin-A and anti-oxLDL antibodies correlated with IMT-inhomogeneity but not with IMT. HsCRP neither correlated with IMT-inhomogeneity nor with IMT.

CONCLUSION

The present study shows that CCA-IMT and IMT-inhomogeneity were increased in dialysis patients compared with controls. Although CCA-IMT and IMT-inhomogeneity are related, the different associations between both measurements and non-traditional risk factors show that they are distinct entities.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine and Nephrology, Academic Hospital Maastricht, PO box 5800, 6202 AZ Maastricht, The Netherlands, and Department of Nephrology and Clinical Immunology, University Hospital RWTH, Aachen, Germany. mherm@sint.azm.nl

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    Source

    MeSH

    Aged
    Blood Proteins
    C-Reactive Protein
    Carotid Artery, Common
    Case-Control Studies
    Cholesterol, LDL
    Cross-Sectional Studies
    Female
    Humans
    Immunoglobulin G
    Kidney Failure, Chronic
    Male
    Middle Aged
    Regression Analysis
    Renal Dialysis
    Risk Factors
    Tunica Intima
    Tunica Media
    Ultrasonography
    alpha-2-HS-Glycoprotein

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    17255127

    Citation

    Hermans, Marc M H., et al. "Spatial Inhomogeneity of Common Carotid Artery Intima-media Is Increased in Dialysis Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 22, no. 4, 2007, pp. 1205-12.
    Hermans MM, Kooman JP, Brandenburg V, et al. Spatial inhomogeneity of common carotid artery intima-media is increased in dialysis patients. Nephrol Dial Transplant. 2007;22(4):1205-12.
    Hermans, M. M., Kooman, J. P., Brandenburg, V., Ketteler, M., Damoiseaux, J. G., Tervaert, J. W., ... Leunissen, K. M. (2007). Spatial inhomogeneity of common carotid artery intima-media is increased in dialysis patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 22(4), pp. 1205-12.
    Hermans MM, et al. Spatial Inhomogeneity of Common Carotid Artery Intima-media Is Increased in Dialysis Patients. Nephrol Dial Transplant. 2007;22(4):1205-12. PubMed PMID: 17255127.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Spatial inhomogeneity of common carotid artery intima-media is increased in dialysis patients. AU - Hermans,Marc M H, AU - Kooman,Jeroen P, AU - Brandenburg,Vincent, AU - Ketteler,Markus, AU - Damoiseaux,Jan G M C, AU - Tervaert,Jan W Cohen, AU - Ferreira,Isabel, AU - Rensma,Pieter L, AU - Gladziwa,Ulrich, AU - Kroon,Abraham A, AU - Hoeks,Arnold P G, AU - Stehouwer,Coen D A, AU - Leunissen,Karel M L, Y1 - 2007/01/25/ PY - 2007/1/27/pubmed PY - 2007/7/25/medline PY - 2007/1/27/entrez SP - 1205 EP - 12 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 22 IS - 4 N2 - BACKGROUND: Structural abnormalities of the common carotid artery (CCA), as assessed by ultrasound techniques, are related to cardiovascular outcome in dialysis patients. An increased intima media thickness (IMT) of the CCA may both represent a reaction to a haemodynamic burden as well as atherosclerosis. With a new ultrasound technique CCA-IMT and IMT-inhomogeneity, a novel parameter of spatial variance of the IMT, were measured and related to traditional and non-traditional risk factors. METHODS: In a cross-sectional study, we included 134 dialysis patients, aged 61+/-13 years (103 on haemodialysis, 31 on peritoneal dialysis) and 41 controls, aged 60+/-8 years. Age, sex, pulse pressure, diabetes, prevalent cardiovascular disease (CVD) and height were included in the basic multiregression analysis. Ultrasound examination of the CCA was performed. We also measured serum fetuin-A, high-sensitivity C-reactive protein (hsCRP), antibodies to oxidized low density lipoproteins (anti-oxLDL antibodies), calcium, phosphate, albumin and parathyroid hormone. RESULTS: Compared with controls, dialysis patients had a greater CCA-IMT (670 microm vs 590+/-10 microm; P=0.002) and a greater CCA-IMT inhomogeneity (11.0 vs 8.1%; P=0.013). Dialysis patients with CVD had a greater CCA-IMT (734 microm vs 631 microm; P=0.001) and IMT-inhomogeneity (13.2 vs 9.7; P=0.008) compared with patients without CVD. IMT-inhomogeneity strongly correlated with IMT (R=0.65, P<0.0001). In multiregression analysis, serum fetuin-A and anti-oxLDL antibodies correlated with IMT-inhomogeneity but not with IMT. HsCRP neither correlated with IMT-inhomogeneity nor with IMT. CONCLUSION: The present study shows that CCA-IMT and IMT-inhomogeneity were increased in dialysis patients compared with controls. Although CCA-IMT and IMT-inhomogeneity are related, the different associations between both measurements and non-traditional risk factors show that they are distinct entities. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/17255127/Spatial_inhomogeneity_of_common_carotid_artery_intima_media_is_increased_in_dialysis_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfl750 DB - PRIME DP - Unbound Medicine ER -