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Features of atherosclerosis in hemodialysis patients
Kyong Ah Park1, Hye Min Jo1, Ji Soo Han1
1Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
Insights
Atherosclerosis, indicated by carotid intima-media thickness (CIMT), is linked to older age in hemodialysis patients. Overweight patients with atherosclerosis face shorter vascular access patency, increasing failure risk.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Vascular Surgery
Background:
- Cardiovascular disease is a leading cause of mortality in patients undergoing hemodialysis.
- Carotid intima-media thickness (CIMT) serves as a marker for early atherosclerosis, a condition linked to vascular access failure.
- Understanding atherosclerosis in hemodialysis patients is crucial for improving outcomes.
Purpose of the Study:
- To identify clinical features of atherosclerosis in hemodialysis patients using CIMT.
- To investigate the relationship between CIMT and vascular access failure in this population.
Main Methods:
- A cross-sectional study involving 60 hemodialysis patients.
- Carotid intima-media thickness (CIMT) assessed via B-mode Doppler ultrasonography.
- Atherosclerosis defined by CIMT ≥ 0.9 mm or presence of plaques.
Main Results:
- Patients with atherosclerosis were older than those without.
- Atherosclerosis was associated with significantly shorter vascular access patency (HR, 2.822; P=0.029).
- Overweight status increased primary access failure risk by 2.47-fold (95% CI, 1.101-5.548).
Conclusions:
- Atherosclerosis in hemodialysis patients is associated with advanced age.
- Overweight patients with atherosclerosis may experience reduced vascular access patency.
- These findings highlight the importance of managing atherosclerosis and weight in hemodialysis patients to preserve vascular access.
Background:
Cardiovascular disease is the main cause of mortality in dialysis patients. Carotid intima-media thickness (CIMT) is used as a surrogate marker of early atherosclerosis. Atherosclerosis can cause vascular access failure. The purpose of this study was to define the clinical features of atherosclerosis in hemodialysis patients based on CIMT and to define the relationship between CIMT and access failure.
Methods:
In this cross-sectional study, the CIMT of 60 patients on hemodialysis was examined using B-mode Doppler ultrasonography between May 2012 and November 2012. Carotid atherosclerosis was defined as a CIMT≥0.9 mm or the incidence of atherosclerotic plaques.
Results:
The patients' mean age was 54.5±10.6 years, and 60% of the patients were male. The CIMT was 0.81±0.47 mm (range, 0.35-2.50 mm). The group with atherosclerosis was characterized by older age compared with those without atherosclerosis. Patients with atherosclerosis showed much shorter durations of access patency than their counterparts in the nonatherosclerosis group (hazard ratio, 2.822; 95% confidence interval, 1.113-7.156; P=0.029). Moreover, being overweight was associated with a 2.47-fold (95% confidence interval, 1.101-5.548) increased primary access failure.
Conclusion:
This study shows that atherosclerosis is associated with older age. Patients who are overweight and have atherosclerosis may have shortened access patency.
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