Calcified plaque is common in the carotid and femoral arteries of dialysis patients without clinical vascular disease

Background. Cardiac and vascular mortality are commonin end-stage renal disease (ERSD) and are often attributed to acceleratedatherosclerosis. Subjects and methods. We studied 24non-diabetic ESRD patients without cardiac or vascular disease (M = 12, F =12) and 24 age-, sex- and race-matched healthy controls. All underwentB-mode ultrasound for carotid and femoral intima-media thickness (IMT) andplaque (% stenosis) together with blood pressure (BP), and echocardiogramsto determine left ventricular mass. Results. Both BPand mean IMT were similar in patients and controls. However, discreteplaque was present in 71% (17/24) of patients compared with 21% (5/24) ofcontrols (P = 0.001), and % stenosis was greater inpatients (carotid 12.2 ± 11% vs 2.3± 5.9%, P <0.0004; femoral 16.4± 19.1% vs 3.1 ± 6.4%,P <0.003). Plaque was soft/atheromatous in 3 ofthe 5 controls, but not in any of the 17 patients (P =0.007), all of whom had calcified lesions. BP and cholesterol were notcorrelated with IMT or plaque in patients, but in control subjects carotidIMT was correlated with systolic BP (r = 0.66,P <0.0005) and diastolic BP(r = 0.45, P <0.03). Inpatients, the only independent variables related to vascular morphologywere serum albumin which was inversely related to IMT(P <0.03) and to plaque (carotidP <0.05, femoral P<0.02) and age, which was related to femoral plaque only(P <0.04). Left ventricular end-diastolicinternal dimension not LVMI, correlated positively with carotid IMT(P <0.04). Conclusion. Ourresults show that calcified plaque is common in ESRD patients andhypoalbuminaemia may be an associated factor. Keywords:B-mode ultrasound; carotid and femoral artery; end-stage renaldisease; calcification