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Inflammation as a risk factor for carotid intimal‐medial thickening, a measure of subclinical atherosclerosis in haemodialysis patients: The role of chlamydia and cytomegalovirus infection
Author(s) -
BUYUKHATIPOGLU HAKAN,
TIRYAKI OZLEM,
TAHTA KADIR,
USALAN CELALETTIN
Publication year - 2007
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.1440-1797.2006.00742.x
Subject(s) - medicine , fibrinogen , chlamydia , lipoprotein(a) , gastroenterology , inflammation , intima media thickness , pathogenesis , c reactive protein , serum amyloid a , risk factor , immunology , endocrinology , lipoprotein , cholesterol , carotid arteries
SUMMARY: Objectives: Atherosclerotic vascular disease is the most frequent complication seen in haemodialysis (HD) patients. Evidence suggests that inflammation may play a role in the pathogenesis and progression of atherosclerosis. Our aim was to evaluate the causative role of inflammation in atherosclerosis among HD patients. Methods: Intima‐media thickness (IMT) in carotid arteries was determined in 54 HD patients and 52 controls. Plasma levels of lipids, glucose, albumin and several acute phase proteins, and immunoglobulin G titres against chlamydia and cytomegalovirus were measured in all subjects. Results: Mean carotid IMT was significantly greater in HD patients than in controls (0.75 mm vs 0.56 mm, P < 0.005). While plasma levels of C‐reactive protein (CRP), serum amyloid A (SAA), lipoprotein (a) Lp(a), fibrinogen and ferritin were higher in HD patients, albumin levels were lower. In HD patients, carotid IMT was correlated positively with CRP ( R = 0.29, P = 0.019), SAA ( R = 0.69, P < 0.001), Lp(a) ( R = 0.42, P = 0.001), fibrinogen ( R = 0.57, P < 0.001) and chlamydia pneumonia immunoglobulin G titres ( R = 0.50, P < 0.001), and negatively with albumin levels ( R = −0.33, P = 0.02); there was no relationship between carotid IMT and hypertension, plasma lipid levels and cytomegalovirus. In multivariate regression analysis, these variables still showed a significant relationship with IMT ( R 2 = 0.694 and P < 0.001). Conclusion: We conclude that atherosclerotic changes are more common in HD patients than in controls, and that inflammatory processes may play a role in the pathogenesis of atherosclerosis.