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Carotid intima media thickness and aortic calcification index closely relate to cerebro‐ and cardiovascular disorders in hemodialysis patients
Author(s) -
Tsushima Megumi,
Terayama Yuriko,
Momose Akishi,
Funyu Tomihisa,
Ohyama Chikara,
Hada Ryukichi
Publication year - 2008
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2007.01925.x
Subject(s) - medicine , pulse wave velocity , intima media thickness , cardiology , hemodialysis , blood pressure , odds ratio , pulse pressure , prospective cohort study , carotid arteries
Aim: Atherosclerosis can be evaluated by carotid intima media thickness (IMT), the aortic calcification index (ACI), and pulse wave velocity (PWV). We investigated which test was most closely related to cerebro‐ and cardiovascular disorders (CCVD) in hemodialysis patients. Methods: Maximum IMT (max‐IMT), ACI, and PWV were examined in 110 hemodialysis patients, using carotid ultrasonography, abdominal CT and a blood pressure pulse wave instrument, respectively. Blood hemoglobin A1c (HbA1c), serum total cholesterol, high density lipoprotein cholesterol, triglyceride, total protein, albumin, high sensitivity C reactive protein (hs‐CRP), and tumor necrosis factor α were measured. The patients were divided into two groups; with and without CCVD and the degree of atherosclerosis was evaluated in each group. Results: Compared to the CCVD (–) group, the CCVD (+) group showed significantly higher percentages of males and diabetic patients, higher levels of HbA1c (5.14 vs 4.83%) and hs‐CRP (0.320 vs 0.167 mg/dL), an older age group (64.5 vs 57.5 years), a greater max‐IMT (2.05 vs 1.19 mm), and a higher ACI (71.8 vs 41.0%); and significantly lower diastolic blood pressure (82.8 vs 89.2 mmHg). Multiple logistic regression analysis showed that the factors influencing the development of CCVD were age (odds ratio: 1.092), ACI (odds ratio: 1.025), and max‐IMT (odds ratio: 2.006). However, PWV did not significantly relate to CCVD. Conclusions: In hemodialysis patients, the ACI and max‐IMT were significantly associated with CCVD, but the association of PWV was weak. A prospective cohort study is warranted to determine the risk factors for CCVD in hemodialysis patients.