Carotid Artery Intima-Media Thickness and Influencing Factors in Hemodialysis Patients

BACKGROUND: To investigate the increase in carotid artery intima-media thickness (IMT) and influencing factors in hemodialysis patients. METHODS: 90 hemodialysis patients were divided into groups according to their dialysis duration; 30 healthy subjects were included as controls. High-frequency Doppler ultrasound was used to calculate the carotid artery IMT in, 12-, 36-, and 60-month groups; biochemical parameters were also measured. Data from different groups were compared and the associations between the risk factors and IMT were investigated. RESULTS: Increased IMT was found in the patients in all groups compared with controls (p < 0.05). IMT was also significantly higher in the 36-month group than in the 12-month group (p < 0.01), while no significant difference in the IMT was found between the 60-month group and the 36-month group. A positive association was found between the carotid artery IMT and systolic pressure (SBP, r = 0.39, p < 0.01), mean arterial pressure (r = 0.291, p < 0.01), C-reactive protein (CRP, r = 0.511, p < 0.01), serum phosphate (r = 0.518, p < 0.01), and calcium-phosphorus product (r = 0.170, p < 0.01); a negative association was found between carotid artery IMT and plasma albumin (r = -0.095, p < 0.01) and prealbumin (r = -0.65, p < 0.01). Multivariate linear regression showed that high SBP (t = 2.004, p < 0.01), high serum phosphate (t = 2.531, p < 0.01), and increased CRP (t = 4.737, p < 0.01) were independent risk factors for IMT increase. CONCLUSIONS: Hemodialysis increased carotid artery IMT associated with dialysis duration; high SBP, high serum phosphate, and increased CRP are independent risk factors for IMT increase, and IMT was also associated with the development of atherosclerosis.