Comparative Study Of Carotid Dilatation In Patients With Kidney Transplantation And Hemodialysis By Color Doppler Sonography

Objective: To evaluate carotid artery distensibility of patients with kidney transplantation (KT) and hemodialysis (HD). To estimate clinical significance and correlation of variant parameter of carotid dilatation in patients with kidney transplantation and hemodialysis by clinical index (pulse pressure, cholesterin, et al.), at the same time, to prove that there was a difference between carotid dilatation of kidney transplantation and hemodialysis patients, in order to offer an evidence of prophylaxis and cure of earlier carotid dilatation decreased by clinic doctors.Methods: systolic and diastolic diameter (SD and DD) of carotid artery in 60 patients with kidney transplangtation and 40 patients with hemodialysis and 30 control subjects was measured using high-frequency ultrasound and color velocity imaging quantification ultrasound (CVIQ) technology between December 2006 and November 2007, and calculating distensibility coefficient(DC) of carotid artery, and contrasting analysis among interclass after blood pressure and age were calibrated. The arterial blood pressure of all patients was < 140/90 mmHg.Results: One hundred and thirty-two subjects who fulfilled the inclusion criteria were enrolled into the study. The mean duration of dialysis for hemodialysis patients and kidney transplantation recipients were 13.70±12.16 months and 8.26±8.17 months, respectively (P=0.006).The mean time post transplant was 31.58±26.23 months. Hemodialysis was applied twice a week to hemolysis patients. The univariate analysis between two the groups indicated that distensbility coefficient and stiffness degree of carotid artery of renal transplant recipients and hemodialysis patients was very significantly different (P<0.05).The significant difference (P=0.000) was present between pulse pressure of hemodialysis patients (7.53±1.50) Kpa and of renal transplant recipients (5.92±1.12) Kpa. Systolic internal diameter of common carotid artery was significant difference between patients with hemodialysis and renal transplantation and healthy subjects (P<0.01). It was no different to distensbility coefficient and stiffness degree (STD) of carotid , pulse pressure and Systolic internal diameter of common carotid artery between kidney transplantation patients and health subjects(P> 0.05). Thickness of carotid atherosclerotic plaque was significant different deviation between patients with hemodialysis and kidney transplantation. The linear correlation between carotid artery distensibility coefficient and pulse pressure was significant (r=-0.556, P=0.002). Distensibility coefficient of carotid artery was linearly correlated to diastasis flow rate in patients with hemodialysis(r=-0.529, t=-2.715, P=0.014) .Conclusions: The elastic properties of arterial wall in dialysis patients are decreased compared dialysis patients with renal transplant recipients and control subjects. The linear correlation between carotid artery distensibility coefficient and pulse pressure was significant. Distensibility coefficient of carotid artery was linearly correlated to diastasis flow rate in patients with hemodialysis. Evaluation of carotid dilatation by color Doppler ultrasound can be considered an evidence of prophylaxis and treatment of clinical cardio-vascular diseases to clinical doctors.