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Abstract: FR-PO348

Carotid Intima-Media Thickness Is a Risk Factor to Cognitive Impairment in Dialysis Patients

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Zheng, Ke, Peking Union Medical College Hospital, Beijing, China
  • Yujun, Qian, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, Beijing, China
  • Wang, Haiyun, Peking Union Medical College Hospital, Beijing, China
  • Li, Xuemei, Peking Union Medical College Hospital, Beijing, China
Background

Carotid atherosclerosis is closely related to cardiovascular and cerebrovascular disease. Carotid intima-media thickness (cIMT) measurement by ultrasound is the most widely used noninvasive imaging method to assess carotid atherosclerosis, and was considered as a risk factor and predictor of CV disease. With growing concern about the cognitive impairment (CI) and cerebral small vascular disease (CSVD) problem in ESRD 5D patients, some studies were designed to explore the risk factors of them, without convincing conclusion. In this study, we evaluated the relationship between CIMT and CSVD, CI.

Methods

In this retrospective studies, we analyzed the carotid artery ultrasound results of our dialysis cohort of 2013~2014 CSVD/CI study in which the CSVD were assessed by magnetic resonance imaging and cognitive function were assessed by a cognitive test battery (including: global cognitive function, verbal memory, language ability and executive function). According to cIMT measurement, patients were divided into normal cIMT group (cIMT<1mm) and increased cIMT group (cIMT≥1mm). Multivariable analysis was used to explore the relevance between cIMT and CSVD, CI.

Results

73 dialysis patients (HD and PD) of our CSVD/CI study cohort of 4 received carotid artery ultrasonography. 54.8% (40/73) was diagnosed as increased cIMT. Compared with normal cIMT group, increased cIMT group, was older (62.4yr vs 52.5yr, p<0.001), with lower serum albumin level (37.4g/Lvs39.4g/L,p=0.046) and lower SCr level (860.7umol/L vs 1007.8umol/L, P=0.010). There were no difference of the prevalence of 3 typical features of CSVD (lacunes, CMBs, and WMHs) between two groups. After multivariable analysis, patients with increased cIMT had a 1.27 fold risk of MMSE score reduce, 2.30 fold risk of MoCA score reduce, 23.53 fold risk of Trails A time delay and 61.56 fold risk of Trails B time delay, but cIMT was not relative to CSVD.

Conclusion

Increased cIMT was an independent risk factor of impairment of global cognitive function, executive function,and the impact of cIMT was not induced by CSVD. Carotid artery ultrasonography may be a useful tool of screening high risk of impaired cognitive function patients.

Funding

  • Government Support - Non-U.S.