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Objective Todeterminethecorrelationbetweenthrombomodulinand atherosclerosis in chronic kidney diseases (CKD) patients.Methods A total of 96 CKD patients in our hospital were enrolled in the study, including 32 maintenance hemodialysis(MHD) patients and 64 non-hemodialysis CKD patients with stage 2 to 5(non-HD) and 30 age- and gendermatched healthy volunteers were used as control.Intima-media thickness(IMT) and atherosclerotic plaquesof theextracranialcommoncarotidarteryweredetectedbyhigh-resolutionB-mode ultrasonography. Bloodlevelof thrombomodulinwasmeasuredusingELISA,andcreatinine,triglycerides, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol were measured routinely as well.Correlation analysis of thrombomodulin with other parameters was performed.Results The thrombomodulin level was significantly higher in CKD patients as compared to healthy controls[(12.15±3.04) mg/L vs(3.12±0.23) mg/L, P＜0.05], and also significantly higher in MHD patients as compared to non-HD patients [(16.89±3.35) mg/L vs (9.78±2.49) mg/L, P＜0.05].The atherosclerotic plaques incidence and IMT value of carotid artery increased significantly in CKD patients compared with healthy volunteers.Thrombomodulin was positively correlated with IMT in CKD patients(r=0.335, P＜0.01).Multiple stepwise regression analysis showed that thrombomodulin, Tm (OR=1.13, 95％CI 1.010-1.121), SBP (OR=1.09, 95％GI 1.009-1.114), CRP(OR=1.22, 95％CI 1.216-2.007), and Scr were independent risk factors of IMT.ConclusionThrombomodulin is correlated with carotid atherosclerosis in CKD patients and may be used as a marker to evaluate the endothelial damage.
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Objective To investigate the association between arterial stiffness of the common carotid artery(CCA)and insulin resistance in hemodialysis patients. Methods Arterial stiffness index β of CCA was evaluated by an ultrasonic phase-lock Echo-tracking system in 80stable non-diabetic hemodialysis patients.Insulin resistance was detected by the homeostasis model assessment method(HOMA-IR).Plasma hemoglobin,serum albumin,total cholesterol,high density lipoprotein,low density lipoprotein,triglyceride,lipoprotein(a),ApoA1,ApoB,CRP,calcium,phosphorus and creatinine were determined by standard methods. Results The stiffness index β was 11.41±4.13 in patients with previous cardiovascular disease(CVD)and 9.75±3.63 in those without CVD(P＜0.05).The stiffness index β was positively correlated with HOMA-IR(r=0.321,P＜0.01),as well as with age(r=0.376,P＜0.01),pulse pressure(r=0.267,P＜0.05),and duration of hemodialysis(r=0.219,P＜0.05).In stepwise multiple regression analysis,HOMA-IR(β=0.228,P＜0.05)and age(β=0.308,P＜0.01)were identified as significant independent variables for stiffness index β of CCA. Conclusions Insulin resistance is associated with aaefial stiffness in nondiabetic hemodialysis patients.The increased arterial stiffness may be the link between insulin resistance and cardiovascular morbidity as well as mortality in hemodialysis patients.
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Objective To determine the relationship between serum adiponectin level and chronic inflammation,atherosclerosis in maintenance hemodialysis(MHD)patients.Methods Totally 60 MHD patients and 30 healthy volunteers were included in this study.Serum adiponectin level(ADPN)and C-reative protein(CRP),interleukin-6(IL-6)were measured.Carotid initial-medial thickness(IMT)and brachial arterial vasodilation were determined by echocardiography.Results Serum ADPN level(0.99?0.37)was higher in MHD patients than that(0.39?0.14)in controls.The ADPN level of higher IMT group was lower than that in normal IMT group.CRP,IL-6 and Cartid IMT were negatively correlated with ADPN(r=-0.22,-0.31-0.26,P
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Objective To investigate the hepatitis C virus(HCV) and hepatitis B virus(HBV) infection in hemodialysis patients in several hemodialysis centers in Beijing.Methods HCV RNA,HBV DNA(PCR) and the serum virus antibody(ELISA) were detected in 225 uremia patients.50 volunteers and the employers in hemodialysis center were also as controls.The relationship between the infection of hepatitis virus and the dialysis time,blood infusion and hepatic function was analysed.Results 37 patients(16.4%) were positive in HCV RNA,3 patients(1.33%) positive in HBV DNA.The logistic analysis showed that blood infusion and the time of hemodialysis were the risk factors.3 patients(3/99,3.0%) were found to be infected with both hepatitis B and C,with disorder of liver function and clinical symptoms.8.1%(8/99) of patients with positive HBcAb were infected with HCV.Conclusion The prevalence of HCV infection in hemodialysis patients is serious.Hemodialysis time and times of blood transfusion are the major ways to transmit HCV.
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Objective To determine the relationship between hyperhomocyseinemia and atherosclerosis in hemodialysis patients.Methods Plasma total homocysteine (tHcy)concentrations were measured by using fluorescence polarization immunoassay.Carotid initial-medial thickness(IMT)was measured by echocardiography.Cardiovascular parameters including carotid Young elastic index and the prevalence of atherosclerosis plaques were calculated by established formulas.Results The prevalence of hyperhomocyseinemia was 68.3% in the hemodialysis patients.The folate and vitamin B_(12) concentrations were higher in patients than those in controls.Cartid IMT,carotid Young elastic index and the prevalence of atherosclerosis plaques were positively and independently correlated with tHcy (r=0.34,0.31,0.23).Multivariate stepwise regression indicated that the correlation also existed independently of other conventional risk factors such as age,sex,blood pressure,Scr,glucose.Conclusion The results indicate that hyperhomocyseinemia may be an independent risk factor for atherosclerosis found in hemodialysis patients.