Lestariningsih Lestariningsih, Hardisaputro Suharyo, Nurani Ayudyah, Santosa Damai, Santoso Gunawan
Division of Nephrology, Department of Internal Medicine, School of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia.
Division of Tropic Infection, Department of Internal Medicine, School of Medicine, Diponegoro University, Semarang, Indonesia.
Int J Gen Med. 2019 Jun 13;12:219-224. doi: 10.2147/IJGM.S205506. eCollection 2019.
Several emerging problems of regular hemodialysis (HD) including cardiovascular complication or atherosclerosis formation caused by chronic inflammation. Intima-media thickness (IMT) of the carotid artery can be applied as a marker of atherosclerosis progression. This study was designed to identify the predictive of IMT progression among end-stage renal disease (ESRD) subject.
This cohort study was performed at the Hemodialysis Unit of Dr. Kariadi Hospital and Telogorejo Hospital Semarang between October 2009 and April 2010. The study subjects were the ESRD patients with regular HD.
This study enrolled 78 subjects with regular HD, follow-up 6 months. The subjects which completed the study were divided into two groups that consist of IMT progressive group (n=53) and IMT non-progressive group (n=12). There were no differences between two groups according to age, gender, history of diabetes, blood pressure, duration of HD, urea, creatinine, blood glucose, HbA1C, cholesterol, triglyceride, HDL, uric acid, phosphate, calcium, homocysteine, and albumin. Subject with high-sensitive C-reactive protein (hsCRP) level >0.52 mg/L had an IMT progression. There was a correlation between hsCRP and the thickening of carotid artery wall after 6-month HD (RR=3.6; 95% CI=2.2-22.9). The subject with hsCRP level >9.00 mg/L after 6-month dialysis progress to thickening of carotid artery wall of >0.03 mm. There was a correlation between hsCRP level (cut-off point: 9.0 m/L) and the progression of the carotid artery wall (RR=2.1; 95% CI=1.3-3.37). Statistically, there was no correlation between IL-6-174 G/C gene and eNOS gene polymorphism with IMT progression.
hsCRP is a significant predictive of IMT progression at hemodialysis subject. IL -174 G/C gene and eNOS gene polymorphism are not significant predictive of IMT progression at hemodialysis subject.
常规血液透析（HD）出现了几个新问题，包括慢性炎症引起的心血管并发症或动脉粥样硬化形成。颈动脉内膜中层厚度（IMT）可作为动脉粥样硬化进展的标志物。本研究旨在确定终末期肾病（ESRD）患者中IMT进展的预测因素。
本队列研究于2009年10月至2010年4月在三宝垄卡里阿迪博士医院和特洛戈雷霍医院的血液透析科进行。研究对象为接受常规HD的ESRD患者。
本研究纳入78例接受常规HD的受试者，随访6个月。完成研究的受试者分为两组，即IMT进展组（n = 53）和IMT非进展组（n = 12）。两组在年龄、性别、糖尿病史、血压、HD持续时间、尿素、肌酐、血糖、糖化血红蛋白、胆固醇、甘油三酯、高密度脂蛋白、尿酸、磷酸盐、钙、同型半胱氨酸和白蛋白方面无差异。高敏C反应蛋白（hsCRP）水平>0.52 mg/L的受试者出现IMT进展。HD 6个月后，hsCRP与颈动脉壁增厚之间存在相关性（RR = 3.6；95%CI = 2.2 - 22.9）。透析6个月后hsCRP水平>9.00 mg/L的受试者颈动脉壁增厚>0.03 mm。hsCRP水平（截断点：9.0 m/L）与颈动脉壁进展之间存在相关性（RR = 2.1；95%CI = 1.3 - 3.37）。统计学上，IL-6 - 174 G/C基因和eNOS基因多态性与IMT进展之间无相关性。
hsCRP是血液透析受试者IMT进展的重要预测指标。IL - 174 G/C基因和eNOS基因多态性不是血液透析受试者IMT进展的重要预测指标。
