Document Detail


Influence of haemodialysis on early markers of atherosclerosis.
MedLine Citation:
PMID:  18518941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: End-stage renal disease (ESRD) patients treated by haemodialysis (HD) have impaired endothelium-dependent vasodilatation and increased intima-media thickness (IMT) of the carotid artery The aim of the study was to analyse the relationships between parameters of chronic HD treatment and non-invasive assessments of preclinical atherosclerosis (endothelial dysfunction and carotid IMT) in ESRD patients on HD. METHODS: Fifty-two (19 females, 33 males) adult patients on chronic maintenance (4.65 +/- 3.29 years) HD aged 59.88 +/- 15.49 years were investigated. Ultrasonographic studies were performed with a 7.5 MHz high-resolution probe. The common carotid artery IMT was measured. Brachial artery diameter was analysed to the rest. In order to assess flow-mediated dilatation (FMD), hyperaemia was induced by a pneumatic cuff, and an analysis of the diameter was performed 1, 2, 3 and 4 min after cuff deflation. RESULTS: Significant differences were found in the average carotid IMT value between subjects with delivered dialysis dose (Kt/V) > or =1.2 and <1.2 (0.89 +/- 0.21 vs 1.04 +/- 0.11, P = 0.0045). A correlation between Kt/V and IMT (r = 0.366, P = 0.004) was demonstrated. FMD values of the brachial artery did not correlate with Kt/V. A correlation between low molecular weight heparin per kg of body mass and maximal percent of FMD was demonstrated (r = -0.242, P = 0.049). The maximal percent of brachial FMD was correlated with absolute difference between pre- and postdialysis pulse pressure values (r = -0.265, P = 0.033). In a partial correlation with haemoglobin as control, a variable significant correlation between total erythropoietin dose and maximal carotid IMT (r = -0.262, P = 0.036) was found. In a multiple linear regression model, Kt/V was independently correlated with carotid IMT values (beta = -0.227, P = 0.0335). CONCLUSION: This study has demonstrated the association between HD procedure and early atherosclerosis markers. HD treatment has to be considered as potential modifying factor in atherosclerosis development.
Authors:
Vedran Kovacic; Dragan Ljutic; Josipa Dodig; Mislav Radic; Darko Duplancic
Publication Detail:
Type:  Journal Article     Date:  2008-06-01
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  13     ISSN:  1440-1797     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  472-9     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Internal Clinic, University Hospital Split, Split, Croatia. vedkovac@inet.hr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atherosclerosis / diagnosis*,  etiology
Biological Markers
Carotid Arteries / pathology
Cross-Sectional Studies
Endothelium, Vascular / physiology
Erythropoietin, Recombinant / therapeutic use
Female
Humans
Linear Models
Male
Middle Aged
Renal Dialysis*
Tunica Intima / pathology
Tunica Media / pathology
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Erythropoietin, Recombinant

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