Common carotid artery intima-media thickness and atherosclerotic plaques in carotid bulb in patients with chronic kidney disease on hemodialysis: a case-control study

The Common Carotid artery Intima-Media Thickness (CCIMT) can reflect systemic atherosclerosis in renal patients on hemodialysis. This study aimed to compare CCIMT measured by color Doppler ultrasonography between two groups including dialytic patients and normal subjects. In this case-control setting, 48 patients with Chronic Kidney Disease (CKD) on hemodialysis (case group) and 46 age and sex-matched healthy subjects (control group) were enrolled in this study. Color Doppler ultrasound was used to measure CCIMT and determine presence of atherosclerotic plaques in carotid bulb in both groups. Various laboratory parameters were also determined. Serum levels of triglyceride, total cholesterol, low-density lipoprotein, fasting sugar, ionized calcium, inorganic phosphorus and magnesium were comparable between the two groups. Hypertension and elevated levels of serum C-reactive protein, as well as the mean levels of serum non-fasting homocysteine and phosphate were significantly higher in the case group. Mean levels of serum high-density lipoprotein and albumin were significantly higher in the controls. Mean maximum CCIMT was significantly higher in the case group than in controls (0.73 +/- 0.15 vs. 0.68 +/- 0.08 mm, p = 0.01) even after adjusting for other confounding variables. Frequency of patients with atherosclerotic plaques in carotid bulbs was not significantly different between case and controls. In conclusion, this study showed that CCIMT is significantly higher in CKD patients on hemodialysis comparing with matched normal counterparts. Furthermore, this difference was independent of other conventional risk factors for atherosclerosis.