B-mode ultrasonography in evaluation of atherosclerosis in chronic haemodialysis patients

Biserka Tirmenštajn Janković (1), Jasmina Strajnić(2) 
(1) Odeljenje nefrologije i hemodijalize, Zdravstveni centar Zaječar
(2) Radiološka služba, Zdravstveni centar Zaječar

Summary:
Cardiovascular disease accounts for approximately 50% of mortality among patients on chronic dialysis. Atherosclerosis significantly contributes to the high incidence of cardiovascular complications and death of uremic patients. However, there are conflicting reports regarding the possibility of an accelerated atherosclerotic process in these patients. The aim of this cross-sectional study was to determine the extent of atherosclerotic lesions in the carotid arteries of patients undergoing maintenance haemodialysis (HD) in comparison to control subjects. 43 stable uremic patients (27M and 16F, mean age 57.7±12.7 years) were included into study and the results were compared with 21 age and gender matched healthy controls. By using high resolution B-mode ultrasonography, intima-media thickness (IMT) and lumen-diameter (LD) were determined and cross-sectional carotid intima-media area (cIM area) was calculated. A semi quantitative subjective scale (visual scoring) was used to grade the size of plaques in the carotid arteries. The ITM did not differ significantly ( 0.73±0.14 vs 0.66±0.13, p = 0.064) between the two groups, but the patients undergoing haemodialysis had significantly increased cIM area (19.2±4.8 vs 15.0±4.3, p=0.001) and LD (7.56±0.94 vs 6.55±0.74, p = 0.000) compared with healthy controls. Moreover, the prevalence of carotid plaques was significantly elevated in HD patients (83.7% vs 52.4%, p=0.007). These results confirmed significantly higher prevalence of atherosclerosis in patients on chronic HD compared with the general population.
Key words: Atherosclerosis, ultrasonography, haemodialysis.