Smoking, blood pressure and serum albumin are major determinants of carotid atherosclerosis in dialysis patients

Lorenzo S. Malatino, Frank A. Benedetto, Francesca Mallamaci, Giovanni Tripepi, Carmine Zoccali, Saverio Parlongo, Sebastiano Cutrupi, Carmela Marino, Vincenzo Panuccio, Maurizio Garozzo, Vincenzo Candela, Ignazio Bellanuova, Alessandro Cataliotti, Francesco Rapisarda, Pasquale Fatuzzo, Grazia Bonanno, Giuseppe Seminara, Benedetta Stancanelli, Filippo Tassone, Carlo Labate

Research output: Contribution to journalArticle

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Abstract

Aim: To investigate the relationship between carotid atherosclerosis and some major cardiovascular risk factors in uremic patients on chronic dialysis. Methods: A cross-sectional study was carried out in 119 unselected dialysis patients (89 on hemodialysis and 30 on chronic ambulatory peritoneal dialysis, CAPD). Fasting blood sampling for serum lipids, albumin, hemoglobin, and echocolour-Doppler evaluation of common carotid arteries were performed in all patients (during the non-dialysis day in hemodialysis patients). In hemodialysis patients BP was measured before and after dialysis; in CAPD patients home BP values were recorded during the month before the study day. Results: Ninety-five patients had at least one plaque and 57 had at least four plaques. Thirty-eight had mild and eleven severe carotid stenosis. In multiple regression models, the mean internal diameter of carotid arteries was explained (R = 0.52, P = 0.0001) by systolic pressure (r = 0.39), serum cholesterol (r = -0.28), age (r = 0.27) and smoking (r = 0.24) while the degree of carotid stenosis was predicted (R = 0.39, P = 0.0001) by age (r = 0.36) and smoking (r = 0.25). The number of atherosclerotic plaques was explained (R = 0.51, P = 0.0001) by age (r = 0.36), smoking (r = 0.25) and pulse pressure (r = 0.20), serum albumin just failing to reach statistical significance (P = 0.06). However, serum albumin was a significant and independent predictor of the number of atherosclerotic plaques (r = -0.26) in hemodialysis patients (n = 89). Sex, diabetes, Kt/V, duration of dialysis treatment, hemoglobin, serum calcium and phosphate did not add any predictive power to the models. Conclusions: In dialysis patients arterial pressure and smoking are associated with carotid atherosclerosis. Serum albumin appears to serve as an independent predictor of carotid atherosclerosis.

Original languageEnglish (US)
Pages (from-to)256-260
Number of pages5
JournalJournal of Nephrology
Volume12
Issue number4
StatePublished - Jul 1 1999

Keywords

  • Atherosclerosis
  • End-stage renal disease
  • Hypertension
  • Serum albumin
  • Smoking

ASJC Scopus subject areas

  • Nephrology

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    Malatino, L. S., Benedetto, F. A., Mallamaci, F., Tripepi, G., Zoccali, C., Parlongo, S., Cutrupi, S., Marino, C., Panuccio, V., Garozzo, M., Candela, V., Bellanuova, I., Cataliotti, A., Rapisarda, F., Fatuzzo, P., Bonanno, G., Seminara, G., Stancanelli, B., Tassone, F., & Labate, C. (1999). Smoking, blood pressure and serum albumin are major determinants of carotid atherosclerosis in dialysis patients. Journal of Nephrology, 12(4), 256-260.