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

• Published in: American journal of kidney diseases Vol. 41; no. 3 Suppl 1; p. S76
• Main Authors: Nishizawa, Yoshiki, Shoji, Tetsuo, Maekawa, Kiyoshi, Nagasue, Kyoko, Okuno, Senji, Kim, Masao, Emoto, Masanori, Ishimura, Eiji, Nakatani, Tatsuya, Miki, Takami, Inaba, Masaaki
• Format: Journal Article
• Language: English
• Published: United States 01.03.2003
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Cohort Studies; Female; Forecasting - methods; Humans; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Renal Dialysis - methods; Renal Dialysis - mortality; Sex Distribution; Survival Rate; Tunica Intima - diagnostic imaging; Tunica Intima - pathology; Tunica Media - diagnostic imaging; Tunica Media - pathology; Ultrasonography - methods; Ultrasonography - statistics & numerical data
• ISSN: 1523-6838
• DOI: 10.1053/ajkd.2003.50090

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. The cohort consisted of 438 patients with ESRD treated with hemodialysis. CA-IMT was measured by high-resolution B-mode ultrasonography. 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. These results indicate that increased CA-IMT is an independent predictor of cardiovascular mortality in the hemodialysis population.