Intima-media thickness of carotid artery predicts cardiovascular mortality in hemodialysis patients

Am J Kidney Dis. 2003 Mar;41(3 Suppl 1):S76-9. doi: 10.1053/ajkd.2003.50090.


Background: Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD). Previous studies showed that patients with ESRD had increased intima-media thickness of the carotid artery (CA-IMT). In the present study, we examined whether CA-IMT would predict cardiovascular mortality in patients with ESRD.

Methods: The cohort consisted of 438 patients with ESRD treated with hemodialysis. CA-IMT was measured by high-resolution B-mode ultrasonography.

Results: During the follow-up period of 30 months, 82 deaths, including 44 cardiovascular fatal events, occurred. Compared with those with CA-IMT less than 1.0 mm, those with moderately increased CA-IMT (1.0 to 2.0 mm) and those with severely increased CA-IMT (>or=2.0 mm) showed a significantly greater risk for death from cardiovascular causes; odds ratios were 3.17 (95% confidence interval [CI], 1.41 to 7.17; P = 0.005) and 10.20 (95% CI, 3.67 to 28.3; P < 0.0001), respectively, in a multivariate Cox analysis including age, sex, duration of hemodialysis therapy, presence of diabetes mellitus, blood pressure, body mass index, and high-density lipoprotein and non-high-density lipoprotein cholesterol levels as covariates. Conversely, CA-IMT was not significantly associated with noncardiovascular mortality.

Conclusion: These results indicate that increased CA-IMT is an independent predictor of cardiovascular mortality in the hemodialysis population.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / mortality*
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology*
  • Cohort Studies
  • Female
  • Forecasting / methods*
  • Humans
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Renal Dialysis / methods
  • Renal Dialysis / mortality*
  • Sex Distribution
  • Survival Rate
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology*
  • Tunica Media / diagnostic imaging
  • Tunica Media / pathology*
  • Ultrasonography / methods
  • Ultrasonography / statistics & numerical data