Changes in carotid intima-media thickness over two years in patients on haemodialysis

To evaluate the progression of carotid intima-media thickness (CIMT) and to search for possible associations between these changes and other risk factors of atherosclerosis for 2 years in stable patients with chronic renal failure (CRF) on haemodialysis (HD).

Study population consisted of 22 patients with newly diagnosed CRF. All patients underwent B-mode ultrasonography of common carotid artery for estimating CIMT and the presence of plaques before and after the first HD session (mean 24.22 +/- 2.14 months). The differences in CIMT before and after long-term HD treatment were compared. Acute phase proteins, calcium-phosphate balance and lipid profile were assessed and anthropometric parameters were measured.

Mean age was 55 +/- 13 years and 10 (45%) of the patients were female. After long-term HD treatment, (mean 24.22 +/- 2.14 months) the mean value for CIMT (0.57 +/- 0.08 mm) was significantly lower than that at baseline (0.68 +/- 0.12 mm) (p = 0.02). Only male gender and smoking were correlated with baseline CIMT. After long-term HD treatment, age, total cholesterol, LDL cholesterol, and triglyceride were related with CIMT. Diabetes and smoking were correlated with CIMT. Presence of plaque before HD only correlated with creatinine level and after long-term HD treatment only correlated with total cholesterol level.

We found that CIMT was significantly decreased 2 years after starting HD. An association between CIMT and other atherosclerotic risk factors (such as age, cholesterol, triglyceride etc.) could not be determined due to a small sample size.