Features of Atherosclerosis in Hemodialysis Patients

Overview

Journal Kidney Res Clin Pract

Specialty Nephrology

Date 2016 Feb 16

PMID 26877938

Citations 7

Authors

Kyong Ah Park

Hye Min Jo

Ji Soo Han

Min Jin Kim

DO Hyung Kwun

Moo Yong Park

Soo Jeong Choi

Jin Kuk Kim

Seung Duk Hwang

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

MSCTA imaging analysis of autologous arteriovenous fistula dysfunction in maintenance hemodialysis patients.

Wang Y, Qin Y, Huang X, Liu W Am J Transl Res. 2024; 16(3):955-963.

PMID: 38586097 PMC: 10994794. DOI: 10.62347/YEGN9292.

Levels of Cell-Free DNA in Kidney Failure Patients before and after Renal Transplantation.

Leotta C, Hernandez L, Tothova L, Arefin S, Ciceri P, Cozzolino M Cells. 2023; 12(24).

PMID: 38132094 PMC: 10741614. DOI: 10.3390/cells12242774.

Melatonin receptor 1A gene polymorphism rs13140012 and serum melatonin in atherosclerotic versus non-atherosclerotic Egyptian ESRD patients: pilot study.

El Aghoury A, Elsayed E, El Kholy N, El Nashar M, Salem T Heliyon. 2020; 6(7):e04394.

PMID: 32685724 PMC: 7358736. DOI: 10.1016/j.heliyon.2020.e04394.

A comprehensive review on apolipoproteins as nontraditional cardiovascular risk factors in end-stage renal disease: current evidence and perspectives.

Vlad C, Burlacu A, Florea L, Artene B, Badarau S, Covic A Int Urol Nephrol. 2019; 51(7):1173-1189.

PMID: 31119518 DOI: 10.1007/s11255-019-02170-w.

Relationship between diet quality and carotid intima-media thickness in people with and without carotid atherosclerosis.

Alissa E, Helmi S, Al-Salmi M J Family Med Prim Care. 2018; 7(3):531-537.

PMID: 30112303 PMC: 6069645. DOI: 10.4103/jfmpc.jfmpc_66_18.

References

Weiss M, Scivittaro V, Anderson J . Oxidative stress and increased expression of growth factors in lesions of failed hemodialysis access. Am J Kidney Dis. 2001; 37(5):970-80. DOI: 10.1016/s0272-6386(05)80013-7. View

Groothoff J, Gruppen M, Offringa M, de Groot E, Stok W, Bos W . Increased arterial stiffness in young adults with end-stage renal disease since childhood. J Am Soc Nephrol. 2002; 13(12):2953-61. DOI: 10.1097/01.asn.0000037677.16961.df. View

Ocak G, Rotmans J, Vossen C, Rosendaal F, Krediet R, Boeschoten E . Type of arteriovenous vascular access and association with patency and mortality. BMC Nephrol. 2013; 14:79. PMC: 3621613. DOI: 10.1186/1471-2369-14-79. View

Dursun I, Poyrazoglu H, Gunduz Z, Ulger H, Yykylmaz A, Dusunsel R . The relationship between circulating endothelial microparticles and arterial stiffness and atherosclerosis in children with chronic kidney disease. Nephrol Dial Transplant. 2009; 24(8):2511-8. DOI: 10.1093/ndt/gfp066. View

Grobbee D, Bots M . Carotid artery intima-media thickness as an indicator of generalized atherosclerosis. J Intern Med. 1994; 236(5):567-73. DOI: 10.1111/j.1365-2796.1994.tb00847.x. View

Hofstra L, Tordoir J, Kitslaar P, Hoeks A, Daemen M . Enhanced cellular proliferation in intact stenotic lesions derived from human arteriovenous fistulas and peripheral bypass grafts. Does it correlate with flow parameters?. Circulation. 1996; 94(6):1283-90. DOI: 10.1161/01.cir.94.6.1283. View

Kalantar-Zadeh K, Rodriguez R, Humphreys M . Association between serum ferritin and measures of inflammation, nutrition and iron in haemodialysis patients. Nephrol Dial Transplant. 2003; 19(1):141-9. DOI: 10.1093/ndt/gfg493. View

Chatzizisis Y, Giannoglou G, Parcharidis G, Louridas G . Is left coronary system more susceptible to atherosclerosis than right? A pathophysiological insight. Int J Cardiol. 2006; 116(1):7-13. DOI: 10.1016/j.ijcard.2006.03.029. View

Lilly M, Lynch J, Wish J, Huff E, Chen S, Armistead N . Prevalence of arteriovenous fistulas in incident hemodialysis patients: correlation with patient factors that may be associated with maturation failure. Am J Kidney Dis. 2012; 59(4):541-9. DOI: 10.1053/j.ajkd.2011.11.038. View

10.

Stenvinkel P, Heimburger O, Paultre F, Diczfalusy U, Wang T, Berglund L . Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int. 1999; 55(5):1899-911. DOI: 10.1046/j.1523-1755.1999.00422.x. View

11.

Glagov S, Zarins C, Giddens D, Ku D . Hemodynamics and atherosclerosis. Insights and perspectives gained from studies of human arteries. Arch Pathol Lab Med. 1988; 112(10):1018-31. View

12.

Amabile N, Guerin A, Leroyer A, Mallat Z, Nguyen C, Boddaert J . Circulating endothelial microparticles are associated with vascular dysfunction in patients with end-stage renal failure. J Am Soc Nephrol. 2005; 16(11):3381-8. DOI: 10.1681/ASN.2005050535. View

13.

Rivera J, Choi E, Yoon Y, Chun E, Choi S, Nasir K . Association between increasing levels of hemoglobin A1c and coronary atherosclerosis in asymptomatic individuals without diabetes mellitus. Coron Artery Dis. 2010; 21(3):157-63. DOI: 10.1097/MCA.0b013e328337ff9b. View

14.

Kawagishi T, Nishizawa Y, Konishi T, Kawasaki K, Emoto M, Shoji T . High-resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int. 1995; 48(3):820-6. DOI: 10.1038/ki.1995.356. View

15.

Campese V, Romoff M, Levitan D, Lane K, Massry S . Mechanisms of autonomic nervous system dysfunction in uremia. Kidney Int. 1981; 20(2):246-53. DOI: 10.1038/ki.1981.127. View

16.

Savage T, Clarke A, Giles M, Tomson C, Raine A . Calcified plaque is common in the carotid and femoral arteries of dialysis patients without clinical vascular disease. Nephrol Dial Transplant. 1998; 13(8):2004-12. DOI: 10.1093/ndt/13.8.2004. View

17.

Kim Y, Choi Y, Kim J, Kim Y, Kim B, Park C . The impact of intima-media thickness of radial artery on early failure of radiocephalic arteriovenous fistula in hemodialysis patients. J Korean Med Sci. 2006; 21(2):284-9. PMC: 2734005. DOI: 10.3346/jkms.2006.21.2.284. View

18.

Gagliardi G, Rossi S, Condino F, Mancuso D, Greco F, Tenuta R . Malnutrition, infection and arteriovenous fistula failure: is there a link?. J Vasc Access. 2010; 12(1):57-62. DOI: 10.5301/jva.2010.5831. View

19.

Moe S . Vascular calcification: Hardening of the evidence. Kidney Int. 2006; 70(9):1535-7. DOI: 10.1038/sj.ki.5001892. View

20.

Joki N, Hase H, Ishikawa H, Fukazawa C, Nakamura R, Imamura Y . Coronary artery disease as a definitive risk factor of short-term outcome after starting hemodialysis in diabetic renal failure patients. Clin Nephrol. 2001; 55(2):109-14. View