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Atherosclerosis in haemodialysis patients without significant comorbidities: Determinants of progression
Author(s) -
ZUMRUTDAL AYSEGUL,
DEMIRCAN SENOL,
SEYDAOGLU GULSAH,
SINGAN METIN,
SEZER SIREN,
OZDEMIR F NURHAN,
HABERAL MEHMET
Publication year - 2006
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2006.00694.x
Subject(s) - medicine , left ventricular hypertrophy , diabetes mellitus , erythrocyte sedimentation rate , cardiology , uric acid , body mass index , prospective cohort study , intima media thickness , vitamin d and neurology , endocrinology , gastroenterology , blood pressure , carotid arteries
SUMMARY: Aim: The aim of this prospective study was to assess the determinants of the progression of carotid artery intima‐media thickness (CA‐IMT) for 1 year in haemodialysis (HD) patients without significant comorbidities. Methods: Fifty‐four HD patients younger than 55 years, without diabetes, obesity and any clinical evidence of cardiovascular disease (29 men, 25 women; mean age 33.3 ± 10 years; mean time on HD 49.4 ± 43 months) were included in the 1‐year study. CA‐IMT was assessed at baseline and after 12 months. The difference in IMT between these two points of time was calculated (ΔCA‐IMT). C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR), haematocrit‐corrected ESR, beta‐2 microglobulin, cardiac troponin I, lipid profile, fibrinogen, homocysteine, CaXP product, intact parathyroid hormone, haematocrit, albumin, uric acid levels, anthropometric parameters (age, body mass index), smoking, hypertension and left ventricular hypertrophy were recorded at baseline. Results: The mean value for CA‐IMT at baseline (0.59 ± 0.05 mm) was significantly lower than that at 12 months (0.64 ± 0.07 mm) ( P < 0.001). CA‐IMT had increased in 41 patients (75.9%). Age ( P = 0.02), CRP ( P = 0.03), beta‐2 microglobulin ( P = 0.001) and left ventricular hypertrophy ( P = 0.01) were independently related with CA‐IMT at baseline. Age ( P = 0.003) and CRP ( P = 0.04) were the independent variables related with CA‐IMT, measured at 12 months. ΔCA‐IMT correlated positively with age ( r = 0.31, P < 0.05). Age and sex were independent predictors of ΔCA‐IMT ( R 2 for the model 0.56). Conclusion: In addition to age and male sex, non‐specific inflammation may have a possible role in the progression of atherosclerosis in HD patients without significant comorbidities.