engleski

The influence of chronic hemodialysis on carotid intima-media thickness progression

INTRODUCTION AND AIMS: INTRODUCTION: ESRD (end- stage renal disease) patients treated by hemodialysis (HD) have increased intima-media thickness (IMT) of the carotid artery The aim of the study was to analyze the relationships between parameters of chronic hemodialysis treatment and carotid IMT in ESRD patients on hemodialysis. METHODS: SUBJECTS AND METHODS: Fifty-two (19 females, 33 males) adult patients on chronic maintenance (5, 653, 29 years) HD aged 60, 8815, 49 years were investigated. Ultrasonographic studies were performed with 7.5 MHz high- resolution probe. Common carotid artery IMT were measured at the beginning of the study, and prospectively after 15 months. RESULTS: RESULTS: Significant differences were found in average carotid IMT at the study beginning between subjects with delivered dialysis dose (Kt/V) >= 1.2 and <1.2 (0, 870, 19 vs. 1, 030, 11 mm, p=0, 002). A correlation between Kt/V and beginning IMT(r=-0, 404, p=0, 002) was demonstrated. It was found significant differences between IMT values at the beginning and at the end of the study (delta IMT)(0, 930, 17 vs. 1, 030, 17 mm ; p<0, 001). Delta IMT was correlated with differences between predialysis and postdialysis pulse pressure (r=0, 372 ; p=0, 008) and with low molecular weight heparin per kg of body mass per dialysis (r=0, 292 ; p=0, 036). In a multiple linear regression model a products of lipid peroxidation measured as FOX (Ferrous Oxidation - Xylenol orange assay) were independently correlated with percent of maximal carotid deltaIMT values (beta =0, 401 ; p=0, 015). CONCLUSIONS: CONCLUSION: This study has demonstrated the association between hemodialysis procedure and carotid IMT as an atheroslerosis marker.

haemodialysis ; adequacy ; hypertension ; treatment ; urea kinetics

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