[Dialysis as a risk factor for development of atherosclerosis]

Atherosclerosis is a major risk factor for increased cardiovascular morbidity and mortality in dialysis patients. First clinical symptoms are usually associated with initial atherosclerotic changes of blood vessels. The aim of this study was ultrasound evaluation of intima media thickness (IMT) of carotid arteries in dialysis patients and its correlation with certain risk factors.

IMT was measured in 45 dialysis patients with no signs of cardiovascular diseases: 15 continuous ambulatory peritoneal dialysis (CAPD) patients, 30 hemodialysis (HD) patients and in 20 healthy controls. IMT was correlated with certain risk factors for atherosclerosis (general parameters--age, gender, duration of dialysis, cause of renal diseases, parameters of nutrition, parameters of calcium and phosphorus metabolism, lipid parameters, blood pressure and smoking).

The mean carotid artery IMT was significantly higher in dialysis patients than in the control group (p < 0.05). In addition, the mean IMT was statistically significantly higher in PD than in HD patients (p < 0.05). In CAPD patients there was a significant correlation between IMT and total and LDL cholesterol. In the second group (HD patients) IMT significantly correlated with diastolic blood pressure, BMI and smoking.

Although atherosclerotic cardiovascular disease may not manifest in dialysis patients, IMT of carotid arteries significantly increases. Major risk factors affecting IMT are lipid disturbances in patients on peritoneal dialysis and hypertension, obesity and smoking in HD patients.