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Atherosclerosis in hemodialysis patients--the role of microinflammation

Sebastjan Bevc1, Samir Sabic, Radovan Hojs

  • 1Clinic for Internal Medicine, Department of Dialysis, University Medical Center Maribor, Maribor, Slovenia. sebastjanb@yahoo.com

Renal Failure
|November 19, 2008
PubMed

Insights

Cardiovascular disease risk in hemodialysis patients is linked to inflammation. Atherosclerosis in these patients correlates with inflammatory markers like interleukin 2 receptor and VCAM-1, suggesting non-traditional risk factors.

Area of Science:

  • Nephrology
  • Cardiology
  • Immunology

Background:

  • Cardiovascular diseases (CVDs) are a leading cause of death in end-stage renal disease (ESRD) patients.
  • Hemodialysis (HD) patients exhibit a higher risk for coronary heart disease than the general population.
  • Traditional risk factors do not fully explain the elevated CVD risk in HD patients.

Purpose of the Study:

  • To investigate correlations between asymptomatic atherosclerosis and inflammatory markers in HD patients.
  • To assess specific inflammatory markers including hsCRP, IL-6, TNF-alpha, IL-2R, ICAM-1, and VCAM-1.
  • To identify potential non-traditional risk factors for CVD in HD patients.

Main Methods:

  • Ninety-five HD patients (56% male, mean age 60 years) were included.
  • B-mode ultrasonography measured intima-media thickness (IMT) and plaque occurrence in carotid arteries.
  • Serum concentrations of inflammatory markers were determined from blood samples.

Main Results:

  • Mean IMT was 0.83 mm; 84% of patients had plaques.
  • Significant correlations were found between IMT and IL-2R (r=0.269, p<0.022) and VCAM-1 (r=0.290, p<0.014).
  • Multiple linear regression analysis indicated a relationship between IMT and IL-2R (p=0.049). No association was found between inflammatory markers and plaques.

Conclusions:

  • Atherosclerosis in HD patients is associated with specific inflammatory markers.
  • Interleukin 2 receptor (IL-2R) and VCAM-1 are identified as potential nontraditional risk factors for atherosclerosis in this population.
  • Inflammation plays a role in the development of atherosclerosis in hemodialysis patients.
Abstract

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