Tight Relations Between Coronary Calcification and Atherosclerotic Lesions in the Carotid Artery in Chronic Dialysis Patients

Aim: Both vascular calcification and atherosclerosis are highly prevalent in patients with end-stage renal disease (ESRD) and have been associated with increased cardiovascular morbidity. Because those two phenomena might be only coincidentally related in chronic haemodialysis (HD) patients, in this study, coronary artery calcification (CAC), common carotid artery intima media thickness (CCA-IMT) and thickness of atherosclerotic plaques in the carotid artery were simultaneously measured.

Methods: In a cross-sectional study of 47 HD patients (31 male, mean age 56.8 +/- 11.4 years, and 16 female, mean age 56.0 +/- 7.5 years) without history of major cardiovascular complications. CCA-IMT and presence and thickness of atherosclerotic plaques were measured with ultrasound and CAC with multidetector computed tomography.

Results: The CAC were present in 70.2% of patients. The mean CAC was 1055 +/- 232, the mean CCA-IMT was 0.96 +/- 0.21. The atherosclerotic plaques in the common carotid arteries were visualized in 38 patients (80.1%), the mean thickness of the atherosclerotic plaque was 1.61 +/- 0.8 mm. We found a significant positive correlation between CAC and CCA-IMT (r = 0.70, P < 0.001). The thickness of atherosclerosis plaque positively correlated with CAC as well as with CCA-IMT (r = 0.60, P < 0.001 and r = 0.7, P < 0.003, respectively).

Conclusion: The study revealed close relationships between CAC, intima media thickness and the thickness of atherosclerotic plaques in dialysis patients. It may indicate that both vascular calcification and atherosclerotic lesions frequently coexist in patients with ESRD and that the intima media thickness could serve as a surrogate marker of vascular calcification.