Atherosclerosis

2003

DOI: 10.1016/s0021-9150(03)00163-1

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Carotid artery lesions and atherosclerotic risk factors in Japanese hemodialysis patients

¹

,

Yasunori Sawayama

²

,

Masashi Tatsukawa

³

et al.

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Carotid Ultrasound Measurements1

J Clin Exp Invest Wwwjceionlineorg Vol 7 No 1 March 20161

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Cited by 33 publications

(23 citation statements)

References 41 publications

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“…In our study, there was a significant increase in IMT in ESRD patients compared with that in the control group. This result is consistent with that of the study carried out by Maeda et al 30 Studies comparing the effects of HD and CAPD on atherosclerosis have been inadequate. According to some authors, atherosclerosis is more frequently encountered in CAPD group, 13,14,16 and according to others, there is no significant difference between the 2 groups.…”

Section: Discussionsupporting

confidence: 91%

Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

2007

Dialysis & Transplantation

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BACKGROUND: Although some studies have found that myocardial infarction and cerebrovascular disease are more common in patients receiving continuous ambulatory peritoneal dialysis (CAPD) than in patients receiving hemodialysis (HD), the results of other studies have not supported these findings. Studies comparing patients receiving HD with patients receiving CAPD have had conflicting results.OBJECTIVE: The aims of this study were to compare the atherosclerotic changes in CAPD and HD patients and to assess which factors might be responsible for atherosclerosis in dialysis patients.METHODS: Enrolled in the study were 33 patients receiving HD, 32 patients receiving CAPD, and 33 controls for a total of 98 participants. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein, lipoprotein (a) (Lp[a]), apolipoprotein A-I, apolipoprotein B (Apo B), apolipoprotein E (Apo E), albumin, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, intact parathyroid hormone (iPTH), and ferritin levels were obtained from all patients. Carotid intima-media thickness (CIMT) and plaque number were calculated using B-mode ultrasonography.RESULTS: Serum TG, Lp(a), Apo B, hs-CRP, fibrinogen, ferritin, and iPTH levels were significantly higher in the dialysis groups than in the control group; whereas HDL, Apo E, and albumin levels were decreased (p Ͻ .05); the others were same in the all groups. However, there was no difference between the HD and CAPD groups in the other lipid parameters except Lp(a) (p Ͻ .05). CIMT and plaque number of the patients treated with dialysis were higher than those of the control group (p Ͻ .01), but were not significantly different between the 2 dialysis groups (p Ͼ .05). CIMT and plaque number were positively correlated with age (r ϭ 0.43; p Ͻ .05) and hs-CRP level (r ϭ 0.40; p Ͻ .05) and negative correlated with serum albumin and hs-CRP levels (r ϭ Ϫ0.37, p Ͻ .05; and r ϭ Ϫ0.25; p Ͻ .05, respectively).CONCLUSIONS: Serum Apo B and Lp(a) levels were higher in the CAPD patients than in the HD patients. CIMT and plaque number were positively correlated with age and hs-CRP level and negatively correlated with serum albumin and hs-CRP levels.

“…In our study, there was a significant increase in IMT in ESRD patients compared with that in the control group. This result is consistent with that of the study carried out by Maeda et al 30 Studies comparing the effects of HD and CAPD on atherosclerosis have been inadequate. According to some authors, atherosclerosis is more frequently encountered in CAPD group, 13,14,16 and according to others, there is no significant difference between the 2 groups.…”

Section: Discussionsupporting

confidence: 91%

Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

2007

Dialysis & Transplantation

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BACKGROUND: Although some studies have found that myocardial infarction and cerebrovascular disease are more common in patients receiving continuous ambulatory peritoneal dialysis (CAPD) than in patients receiving hemodialysis (HD), the results of other studies have not supported these findings. Studies comparing patients receiving HD with patients receiving CAPD have had conflicting results.OBJECTIVE: The aims of this study were to compare the atherosclerotic changes in CAPD and HD patients and to assess which factors might be responsible for atherosclerosis in dialysis patients.METHODS: Enrolled in the study were 33 patients receiving HD, 32 patients receiving CAPD, and 33 controls for a total of 98 participants. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein, lipoprotein (a) (Lp[a]), apolipoprotein A-I, apolipoprotein B (Apo B), apolipoprotein E (Apo E), albumin, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, intact parathyroid hormone (iPTH), and ferritin levels were obtained from all patients. Carotid intima-media thickness (CIMT) and plaque number were calculated using B-mode ultrasonography.RESULTS: Serum TG, Lp(a), Apo B, hs-CRP, fibrinogen, ferritin, and iPTH levels were significantly higher in the dialysis groups than in the control group; whereas HDL, Apo E, and albumin levels were decreased (p Ͻ .05); the others were same in the all groups. However, there was no difference between the HD and CAPD groups in the other lipid parameters except Lp(a) (p Ͻ .05). CIMT and plaque number of the patients treated with dialysis were higher than those of the control group (p Ͻ .01), but were not significantly different between the 2 dialysis groups (p Ͼ .05). CIMT and plaque number were positively correlated with age (r ϭ 0.43; p Ͻ .05) and hs-CRP level (r ϭ 0.40; p Ͻ .05) and negative correlated with serum albumin and hs-CRP levels (r ϭ Ϫ0.37, p Ͻ .05; and r ϭ Ϫ0.25; p Ͻ .05, respectively).CONCLUSIONS: Serum Apo B and Lp(a) levels were higher in the CAPD patients than in the HD patients. CIMT and plaque number were positively correlated with age and hs-CRP level and negatively correlated with serum albumin and hs-CRP levels.

“…Both carotid arteries scanned with high-resolution Bmode ultrasound using a 7.5 MHz mechanical sector transducer on the Aloka SSD-2000 (Aloka co., Ltd., Tokyo, Japan) by four trained physicians as described previously (17)(18)(19)(20). The maximum IMT was measured 2 to 3 cm proximal to the flow divider on the far wall of the right and left common carotid arteries at the end of the diastolic phase.…”

Section: Carotid Ultrasound Measurementsmentioning

confidence: 99%

Pravastatin Improves Insulin Resistance in Dyslipidemic Patients

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²

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³

et al. 2005

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To evaluate the effect of pravastatin on both lipid and glucose metabolism, twentytwo consecutive dyslipidemic patients treated with pravastatin at 10 mg/day for one year were enrolled in this study. The meal test, which consisted of 115 g of cookies (energy 560 kcal; glucose 75 g; protein 7 g; fat 24 g), was conducted before and after one year of treatment. Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR), by the area under the IRI curve (AUC-IRI), and by the formula AUC-IRI × × × × × AUC-PG. After one year of treatment with pravastatin, the plasma glucose (PG), immunoreactive insulin (IRI) and C-peptide levels were unchanged after fasting and at 120 minutes after the meal test; however, PG, IRI and Cpeptide levels at 60 minutes after the meal were all significantly decreased from baseline (p < 0.05). AUC-IRI and AUC-IRI × × × × × AUC-PG were also significantly decreased (p < 0.05). HOMA-IR was reduced by 26.8%, but the reduction was not significant. The triglyceride (TG) level was decreased after fasting and increased at 60 and 120 minutes after the meal test, but not significantly. This study demonstrated that pravastatin not only reduced serum lipids, but also improved the glucose metabolism, including insulin resistance, of dyslipidemic patients. J Atheroscler Thromb, 2005; 12: 322-329.

“…Atherothrombotic infarction is attributable to atherosclerosis in the large arteries. Carotid atherosclerosis detected by ultrasonography was significantly more prevalent in hemodialysis patients than in healthy residents (11). Another investigation suggested that reduced eGFR was inversely correlated with increasing incidence of coronary artery stenosis (12).…”

Section: Discussionmentioning

confidence: 98%

“…As decreased GFR is associated with the severity of white matter hyperintensity on magnetic resonance imaging (MRI), it has been regarded as a marker of cerebral small-vessel disease (8)(9)(10). The relationship between renal dysfunction and atherosclerosis in large arteries has also been investigated in patients on hemodialysis or with coronary artery disease (11,12). However, the relationship of renal dysfunction to early atherosclerosis in apparently healthy subjects has not been well documented.…”

Section: Introductionmentioning

confidence: 99%

Is Mild Renal Dysfunction a Risk Factor for Carotid Atherosclerosis in Apparently Healthy Adults?

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²

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³

et al. 2011

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Objective Renal dysfunction may be related to cerebrovascular disease. The aim of this study was to assess the relationship between mild renal dysfunction and carotid artery atherosclerosis detected by ultrasonography in apparently healthy subjects. Methods A total of 2,106 persons (1,368 men and 738 women, mean age+/-S.D.: 56 +/-10 years) with no history of stroke were enrolled. Kidney function was evaluated in terms of estimated glomerular filtration rate (eGFR), calculated by using the relationship 194Cr -1.094 ×Age -0.287 ×0.739 (if female), where Cr is serum creatinine concentration. Atherosclerosis on ultrasonography was defined as regional intimal thickening or nodular lesion. Results Atherosclerotic lesions were significantly more frequent in subjects with CKD stage 3 than in CKD stage 1 or 2 (p<0.001). Odds ratios for atherosclerotic lesions were significantly increased to 1.11 (95% confidence interval: 1.09-1.12, p<0.001) for increasing age, 1.66 (1.31-2.10, p<0.001) for male sex, 1.76 (1.43-2.16, p<0.001) for systolic blood pressure !130 mmHg and/or diastolic blood pressure !85 mmHg, 1.61 (1.28-2.01, p<0.001) for LDL-cholesterol !140 mg/dL, and 1.59 (1.23-2.05, p=0.003) for smoking habit versus no risk factor. The odds ratio of CKD stage 3 for !50% carotid artery stenosis was significantly increased to 3.47 (1.09-11.08, p=0.035), although CKD stage 2 and stage 3 were not significant (0.77, 95% CI: 0.59-1.01, p=0.068; 0.99, 95%CI: 0.67-1.46, p=0.981, respectively). Conclusion Renal dysfunction defined in terms of eGFR might be associated with early-stage carotid atherosclerosis, but traditional vascular risk factors, including increasing age or hypertension, appear to play a major role.

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