Carotid atherosclerosis and cardiovascular risk factors in hemodialysis and peritoneal dialysis patients


Yilmaz F. M. , Akay H., Duranay M., Yilmaz G., Öztekin P. S. , Koşar U., ...More

Clinical Biochemistry, vol.40, no.18, pp.1361-1366, 2007 (Journal Indexed in SCI Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 18
  • Publication Date: 2007
  • Doi Number: 10.1016/j.clinbiochem.2007.07.017
  • Title of Journal : Clinical Biochemistry
  • Page Numbers: pp.1361-1366
  • Keywords: Cardiovascular diseases, Carotid atherosclerosis, Hemodialysis, Homocysteine, hs-CRP, Lipoprotein(a), Peritoneal dialysis, Sialic acid, Thiobarbituric acid-reactive substances

Abstract

Background: Cardiovascular diseases are important factors in mortality and morbidity of dialysis patients. Cardiovascular risk assessment is important in order to arrange the treatment strategies. The aim of the study was to investigate the relationship between carotid atherosclerosis and various CVD risk factors in dialysis patients. Methods: 22 HD and 54 PD patients were included in the study. Carotid artery intima media thickness (IMT) and plaque score (PS) were obtained by B-mode ultrasonography for each participant. Uric acid, albumin, bilirubin, lipid profile, apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], high-sensitivity CRP (hs-CRP), homocysteine (Hcy), vitamin A, vitamin E, sialic acid (SA) and thiobarbituric acid-reactive substances (TBARS) were determined. The differences of the cardiovascular risk factors between the patients according to the treatment modality and the comparison of the risk factors as indicators of IMT and PS were investigated. Results: There was no significant difference in IMT and PS between the two groups. SA, TBARS, hs-CRP, total, HDL- and LDL-cholesterol, white blood cell (WBC) and erythrocyte sedimentation rate (ESR) levels were significantly higher; albumin levels were significantly lower in PD group. In multiple regression analysis, only bilirubin for IMT and SA for PS were independent predictors. Conclusions: SA can be a superior marker to hs-CRP in PD patients; however, hs-CRP seems to be a more valuable marker than SA in HD patients according to the correlation analysis. This study provides information and opportunity for comparison of relatively new cardiovascular risk markers in hemodialysis and peritoneal dialysis patients using carotid atherosclerosis as an objective assessment criterion. © 2007 The Canadian Society of Clinical Chemists.