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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Peripheral obstructive arterial disease and carotid artery stenosis in end stage renal disease: a case-control study

S Bilancini1, M Lucchi, R A Mangiafico

  • 1J. F. Merlen Vascular Diseases Research Center, Frosinone, Italy. silviasilvietta@ libero.it

Minerva Cardioangiologica
|December 19, 2008
PubMed

Insights

Patients undergoing dialysis have a significantly higher prevalence of carotid stenosis and peripheral obstructive arterial disease (POAD) compared to the general population. These findings highlight the increased cardiovascular risk in end-stage renal disease patients.

Area of Science:

  • Vascular Medicine
  • Nephrology
  • Cardiology

Background:

  • Cardiovascular diseases are a leading cause of mortality in end-stage renal disease (ESRD) patients.
  • ESRD patients exhibit a higher burden of atherosclerosis, necessitating investigation into specific vascular pathologies.

Purpose of the Study:

  • To compare the prevalence of carotid stenosis (CS) and peripheral obstructive arterial disease (POAD) in dialysis patients versus a control group.
  • To identify risk factors and characteristics of vascular disease in ESRD.

Main Methods:

  • A case-control study involving 40 dialysis patients and 58 matched controls.
  • Utilized Eco-Color Doppler of aorta and lower extremities, and measured Ankle-Brachial Index (ABI).
  • Carotid stenosis defined as ≥50% luminal narrowing.

Main Results:

  • Dialysis patients showed a higher prevalence of CS (20% vs. 12%) and POAD (20% vs. 9%) compared to controls.
  • Adjusted odds ratios indicated significantly increased risk for CS (OR 7.9) and POAD (OR 6.3) in dialysis patients.
  • Ultrasound revealed "rosary bead" calcifications, particularly in sub-popliteal arteries.

Conclusions:

  • Dialysis patients exhibit a substantially higher prevalence of both carotid stenosis and peripheral obstructive arterial disease.
  • The observed vascular lesions are characterized by significant calcification, suggesting accelerated atherosclerosis.
  • Diabetic dialysis patients face an even greater risk, underscoring the need for aggressive cardiovascular risk management.
Abstract

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