The association between fatal vascular events and risk factors for carotid atherosclerosis in patients on maintenance hemodialysis: plaque number of dialytic atherosclerosis study

Atherosclerosis. 2009 Jun;204(2):549-55. doi: 10.1016/j.atherosclerosis.2008.09.028. Epub 2008 Oct 8.


Atherosclerotic vascular diseases are a major cause of morbidity and mortality for end-stage renal disease patients. We followed prospectively 226 hemodialysis patients by carotid ultrasonography to determine if ultrasonographic markers are predictive of the prognosis of these patients. The end-point was death or completion of the five-year follow-up period. Fatal cerebrovascular and cardiovascular events were the most common cause of death. By multivariate analysis, diabetes mellitus (DM) (P=0.005), plaque number (PN) by ultrasonography (P=0.023), age (P=0.001), calcium-phosphate product (P=0.049), and serum albumin (P=0.009) were extracted as independent risk factors. The five-year increase of PN was significantly greater for DM patients than for non-DM patients. Moreover, PN was an independent marker of a fatal event, irrespective of DM status. Our results suggest that PN may be a useful predictor of the long-term prognosis of hemodialysis patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asians / statistics & numerical data
  • Calcium Phosphates / blood
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / ethnology
  • Carotid Artery Diseases / etiology*
  • Carotid Artery Diseases / mortality
  • Diabetes Mellitus / mortality
  • Female
  • Humans
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / ethnology
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / mortality
  • Risk Assessment
  • Risk Factors
  • Serum Albumin / metabolism
  • Severity of Illness Index
  • Time Factors
  • Ultrasonography
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / ethnology
  • Vascular Diseases / etiology*
  • Vascular Diseases / mortality


  • Calcium Phosphates
  • Serum Albumin
  • calcium phosphate