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ORIGINAL ARTICLE
Year : 2015  |  Volume : 7  |  Issue : 6  |  Page : 281-287

Impact of carotid intima-media thickness on long-term outcome in hemodialysis patients


1 Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Geriatric ICU, King George Medical University, Lucknow, Uttar Pradesh, India
3 Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India
4 Department of Statistics, Indian Toxicology and Research Centre, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Munna Lal Patel
Department of Medicine, King George Medical University, C-28, Sector-J, Aliganj, Lucknow - 226 024, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-2714.159339

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Background: Chronic kidney disease (CKD) patients on hemodialysis are highly prone to cardiovascular disease, which accounts for roughly half of the mortality in these patients. Atherosclerosis begins many years before the development of clinical manifestations. Measurement of carotid intima-media thickness (CIMT) is a noninvasive procedure to detect early atherosclerotic changes. Aims: The aim of the study was to evaluate the correlation between CIMT and cardiovascular risk factors and to investigate its prognostic significance in CKD patients on hemodialysis. Materials and Methods: This was a prospective study carried out over a period of 18 months. Total 88 patients on hemodialysis and 50 healthy controls were enrolled in the study. Biochemical assay and CIMT was assessed using the high resolution 7.5 MHz sonography technique in all subjects. Results: Significant positive correlation was found with age, blood urea, serum creatinine, serum triglyceride, low-density lipoprotein, serum phosphorus, serum calcium-phosphorus product, serum uric acid, 24 h urine protein, systolic blood pressure, diastolic blood pressure, and body mass index. Negative correlation was found with estimated glomerular filtration rate. Adjusted hazards ratios of all cause and cardiovascular mortality for an increase of 0.1 mm in CIMT was 1.16 (95% confidence interval 0.15-9.09). Patients with CIMT value <0.97 mm had a renal survival rate of 73.4% while patients with value >0.97 mm had a renal survival rate of 16.5%. Conclusion: Uremia is an additive risk factors in those subjects who have raised CIMT despite of traditional cardiovascular risk factors.


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