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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Advanced atherosclerosis in predialysis patients with chronic renal failure

Tetsuo Shoji1, Masanori Emoto, Tsutomu Tabata

  • 1Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Japan. t-shoji@med.osaka-cu.ac.jp

Kidney International
|May 25, 2002
PubMed

Insights

Chronic renal failure, not hemodialysis, significantly increases carotid artery intima-media thickness (CA-IMT). This suggests renal failure itself drives advanced atherosclerosis in these patients, independent of dialysis treatment.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Vascular Biology

Background:

  • Atherosclerosis is accelerated in hemodialysis patients, evidenced by increased carotid artery intima-media thickness (CA-IMT).
  • It remains unclear if hemodialysis treatment or underlying chronic renal failure (CRF) drives this accelerated atherosclerosis.

Purpose of the Study:

  • To investigate the independent effects of chronic renal failure and hemodialysis treatment on CA-IMT.

Main Methods:

  • Carotid artery intima-media thickness (CA-IMT) was measured using high-resolution B-mode ultrasonography.
  • Study included 110 patients with CRF before dialysis, 345 hemodialysis patients, and 302 healthy controls.
  • All participants were nondiabetic and comparable in age and gender.

Main Results:

  • Both CRF and hemodialysis groups exhibited significantly greater CA-IMTs compared to healthy controls.
  • No significant difference in CA-IMT was observed between CRF and hemodialysis groups.
  • Multiple regression analysis identified renal failure, not hemodialysis, as a significant independent factor associated with increased CA-IMT.

Conclusions:

  • Arterial wall thickening (atherosclerosis) is present in patients with chronic renal failure even before dialysis initiation.
  • Findings support the hypothesis that advanced atherosclerosis in hemodialysis patients is primarily due to renal failure and associated metabolic abnormalities, rather than the hemodialysis treatment itself.
Abstract

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