Ankle-Brachial Index and Carotid Intima-Media Thickness Progression by Using Ultrasound Among Patients With HIV Infection Versus End-Stage Renal Disease

Abstract

Human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) patients contributed to accelerated cardiovascular disease. Comparing the effect on atherosclerosis of the 2 diseases has never been explored. A prospective cohort study enrolled participants who were more than 18 years of age without stroke, coronary, and peripheral arterial disease events. Each HIV-infected person had continuously used antiretroviral therapy and ESRD and required intermittent hemodialysis. We assessed patients using the ankle-brachial index (ABI) and carotid intimal media thickness (CIMT) at enrollment, and 1 year later. The main outcome was the progression of ABI and CIMT per year. Demographic, comorbidities, and serum profiles were collected on entry. A total of 789 HIV-positive and 41 ESRD with HIV-negative patients were recruited. After adjusting for potential confounders at baseline, the ESRD die not significantly decrease ABI by 0.015 in 1 year (P=0 .252). The HIV-infected group had a significantly decreased ABI by 0.020 in 1 year (P < .001), but the reduced rate in the HIV-infected group was not statistically different from those in the ESRD group (P = 0.901). When adjusted for potential confounders, the ESRD had a significant increase of CIMT by 0.111 mm in 1 year (P<0.001). The HIV patients had a significant increase of 0.250 mm CIMT in 1 year (P<0.001). This progression rate was statistically greater in the HIV-infected group versus the ESRD group. HIV infection and ESRD had comparable rates of ABI and CIMT progression in our study. Then, early prevention in asymptomatic atherosclerosis should include not only patients with ESRD but also HIV-infected patients.

Impact of Enhanced Lipid Peroxidation on Carotid Artery Intima Media Thickness Ratio in Patients Receiving Maintenance Hemodialysis

“…The carotid intima media thickness usually means the maximum thickness of the carotid bulb. 10 Normal upper range of intima/media thickness is 0.49-0.85 mm in men and from 0.50-0.89 mm in women. 10 This study will help the nephrologists in early detection and treatment of atherosclerotic changes in hemodialysis patients and hence improve the morbidity and mortality in these patients.…”

“…9 Hence elevated levels of Ox-LDL are associated with accelerated atherogenesis. 10 To estimate the risk of atherosclerotic disease, detection of the levels of Ox-LDL can serve as an important biomarker.…”

Association of Elevated Oxidized Low Density Lipoprotein to Low Density Lipoprotein Ratio (Ox LDL/LDL) with Sub Clinical Atherosclerosis in Patients Receiving Maintenance Haemodialysis

“…Oxidative Stress also leads to decreased availability of Nitric oxide which causes endothelial dysfunction 11,12 . Thus the vascular tone is directly affected.…”

Ultrasound: The Magic Wand for Wound Healers

“…Tungsrirut et al 9 have examined the diagnostic performance of the ankle-brachial index and the pole test by Doppler ultrasound to detect peripheral arterial disease in patients with end-stage renal disease. Rerkasem et al 10 have compared findings with ankle-brachial index and carotid intima media thickness by ultrasound in patients with end-stage renal disease and those with human immunodeficiency virus (HIV) infection and indicate the potential value of intima-media thickness measurements in the latter cohort as well.…”