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Impact of Carotid Intima-Media Thickness on Long-term Outcome in Hemodialysis Patients.

Patel ML - N Am J Med Sci (2015)

Bottom Line: 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.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%.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Receiver operator curve for carotid intima-media thickness (CIMT) considering mortality as a status variable. The area under curve for CIMT was 0.725 (95% confidence interval [CI]: 0.619-0.815). A CIMT cut-off of 0.97 (unit required) had a sensitivity of 88.97% and specificity of 72.88% in predicting the mortality. The +likelihood ratio (LR) value of 2.54 (95% CI 1.6-4.1) and -LR value of 0.43 (95% CI 0.2-0.7)
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Figure 1: Receiver operator curve for carotid intima-media thickness (CIMT) considering mortality as a status variable. The area under curve for CIMT was 0.725 (95% confidence interval [CI]: 0.619-0.815). A CIMT cut-off of 0.97 (unit required) had a sensitivity of 88.97% and specificity of 72.88% in predicting the mortality. The +likelihood ratio (LR) value of 2.54 (95% CI 1.6-4.1) and -LR value of 0.43 (95% CI 0.2-0.7)

Mentions: Univariate cox proportional regression analysis revealed that various factors such as age, the product of calcium and phosphorus, albumin, and CIMT were associated with all-cause mortality. Multivariate regression analysis demonstrated that albumin and CIMT became significant independent predictors of all-cause mortality. Adjusted hazards ratios of all cause and cardiovascular mortality for an increase of 0.1 mm in CIMT was 1.16 (95% confidence interval [CI]: 0.15-9.09) [Table 5]. 0.1 mm increment of CIMT also increased the risk of cardiovascular mortality by 16% (95% CI: 0.15-9.09) in patients who have otherwise no history of any cardiovascular events [Tables 5 and 6]. The AUC for CIMT was 0.725 (95% CI: 0.619-0.815). A CIMT cut-off of 0.97 had a sensitivity of 88.97% and specificity of 72.88% in predicting the mortality. The +likelihood ratio (LR) value of 2.54 (95% CI 1.6-4.1) and -LR value of 0.43 (95% CI 0.2-0.7) [Figure 1].


Impact of Carotid Intima-Media Thickness on Long-term Outcome in Hemodialysis Patients.

Patel ML - N Am J Med Sci (2015)

Receiver operator curve for carotid intima-media thickness (CIMT) considering mortality as a status variable. The area under curve for CIMT was 0.725 (95% confidence interval [CI]: 0.619-0.815). A CIMT cut-off of 0.97 (unit required) had a sensitivity of 88.97% and specificity of 72.88% in predicting the mortality. The +likelihood ratio (LR) value of 2.54 (95% CI 1.6-4.1) and -LR value of 0.43 (95% CI 0.2-0.7)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488996&req=5

Figure 1: Receiver operator curve for carotid intima-media thickness (CIMT) considering mortality as a status variable. The area under curve for CIMT was 0.725 (95% confidence interval [CI]: 0.619-0.815). A CIMT cut-off of 0.97 (unit required) had a sensitivity of 88.97% and specificity of 72.88% in predicting the mortality. The +likelihood ratio (LR) value of 2.54 (95% CI 1.6-4.1) and -LR value of 0.43 (95% CI 0.2-0.7)
Mentions: Univariate cox proportional regression analysis revealed that various factors such as age, the product of calcium and phosphorus, albumin, and CIMT were associated with all-cause mortality. Multivariate regression analysis demonstrated that albumin and CIMT became significant independent predictors of all-cause mortality. Adjusted hazards ratios of all cause and cardiovascular mortality for an increase of 0.1 mm in CIMT was 1.16 (95% confidence interval [CI]: 0.15-9.09) [Table 5]. 0.1 mm increment of CIMT also increased the risk of cardiovascular mortality by 16% (95% CI: 0.15-9.09) in patients who have otherwise no history of any cardiovascular events [Tables 5 and 6]. The AUC for CIMT was 0.725 (95% CI: 0.619-0.815). A CIMT cut-off of 0.97 had a sensitivity of 88.97% and specificity of 72.88% in predicting the mortality. The +likelihood ratio (LR) value of 2.54 (95% CI 1.6-4.1) and -LR value of 0.43 (95% CI 0.2-0.7) [Figure 1].

Bottom Line: 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.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%.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus