Background: Patients with end-stage renal disease are known to have insulin resistance and advanced arterial stiffness. The present study was undertaken to investigate whether insulin resistance was correlated with carotid arterial stiffness in hemodialysis patients. Methods: Eighty nondiabetic hemodialysis patients were recruited. Stiffness index β of the common carotid artery was assessed by ultrasound using echo-tracking system. Insulin resistance was evaluated by the homeostasis model assessment method (HOMA-IR). Serum albumin, lipid profile, calcium, phosphorus, intact parathyroid hormone, high-sensitivity C-reactive protein and oxidized low-density lipoprotein (ox-LDL) were also measured. Results: Patients with higher HOMA-IR levels had higher BMI, ox-LDL, and stiffness index β than patients with lower HOMA-IR levels. HOMA-IR was independently correlated with stiffness index β (β = 0.260, p = 0.016). BMI and ox-LDL were independent contributors to HOMA-IR. Conclusion: Insulin resistance assessed by HOMA-IR is closely associated with carotid arterial stiffness in nondiabetic hemodialysis patients.

Objective: To evaluate the value of intraoperative laparoscopic ultrasonography (ILUS) in retrolaparoscopic nephron-sparing surgery. Methods: A total of 81 cases were studied during a 5-year period: 38 patients with a benign renal tumor who underwent enucleation of the tumor and 43 patients with a suspected malignant renal tumor who underwent wedge resection of the tumor. ILUS was used to evaluate renal perfusion, locate the tumor, precisely delineate the tumor border, characterize the tumor, and look for any suspected satellite renal masses. Results: All procedures were successful without conversion to open surgery. The mean operating time was 106 min for enucleation (range 70– 150 min) and 114 min for wedge resection (range 80– 235 min). The mean size of benign tumors was 4.02 cm and that of malignant tumors was 3.13 cm, and all margins were negative. An additional renal artery branch was detected in 11 patients. In 2 cases the operative procedure was changed based on the ILUS findings. No satellite lesion was found in any of the patients with malignant tumors. Conclusions: ILUS provides significant benefit in retrolaparoscopic nephron-sparing surgery. In a number of situations, especially endogenic lesions, it is an essential surgical tool.

No abstract

This study aims to investigate the correlation between carotid elasticity in hemodialysis patients as evaluated by ultrasound echo-tracking technology and aortic pulse wave velocity. A total of 103 patients with end-stage renal disease who underwent stable hemodialysis were enrolled. An ultrasonic echo-tracking method was used to evaluate the elastic modulus and the stiffness index (β), which were compared with pulse wave velocity (PWV). Blood glucose, blood lipids, and serum creatinine were also tested. These indices were analyzed to determine the independent factor for arterial elasticity. The carotid elastic modulus and β were in good correlation with PWV among hemodialysis patients (P = 0.000). Diabetes and age are independent risk factors for arterial elasticity among hemodialysis patients. Ultrasound echo-tracking technology is a sensitive and accurate method for evaluating arterial elasticity and is a good alternative to traditional PWV.