The Existence of Plaque in Carotid Artery Predicts Cardiovascular Death in Patients with End-Stage Renal Disease on Maintenance Hemodialysis.

BACKGROUND

Atherosclerosis progresses after starting renal replacement therapy, and it contributes to high cardiovascular mortality. Carotid intima-media thickness (CIMT) and plaque offer a convenient method to explore the status of systemic atherosclerosis. The aim of this cohort study was to determine the significance of carotid plaque and other factors that may impact the clinical outcomes of end-stage renal disease (ESRD) patients.

METHODS

Two hundred and sixty-five patients who received maintenance hemodialysis for more than 3 months were enrolled in the study and closely followed for 2 years with clinical events recorded. The primary endpoint was cardiovascular death.

RESULTS

During the 2-year follow-up period, 11.7% of the patients died from cardiovascular causes; however none were caused by stroke. The patients with carotid plaques were older and had thicker left CIMT and right CIMT, lower serum albumin, higher alanine aminotransferase, higher serum glucose, lower serum creatinine, and higher rates of cardiovascular death and overall mortality. Logistic regression analysis showed that the existence of carotid plaque (odds ratio 3.39, 95% confidence interval: 1.577-7.292, p = 0.002) was significantly correlated with the primary outcome. Plaque also significantly impacted overall survival (log-rank p = 0.024).

CONCLUSIONS

The presence of carotid plaque was a risk factor for cardiovascular death in patients with ESRD.