CIMT was no longer significantly associated with CV events after adjustment for diabetes in the limited model, whereas local ufPWV parameters were not significantly associated with CV events or all-cause mortality in the overall MHD population.
MHD patients exhibited significantly higher CIMT compared to non-ESRD controls.
During follow-up, 21 cardiovascular events and 17 deaths were recorded in the MHD cohort.
CIMT was associated with CV events in univariable analysis but this association was lost after adjusting for diabetes.
Neither PWV-BS nor PWV-ES was associated with CV events or all-cause mortality in the overall MHD cohort.
In a preliminary subgroup analysis of diabetic patients, an inverse association was observed between left PWV-ES and CV events.
Diabetes was identified as an important confounding factor in the relationship between CIMT and cardiovascular outcomes in MHD patients.
This research examined whether two types of ultrasound-based measurements of artery health — carotid intima-media thickness (CIMT, a measure of artery wall thickening) and ultrafast pulse wave velocity (a measure of artery stiffness) — could predict heart disease events and death in patients on long-term kidney dialysis. The study followed 115 dialysis patients for about three years and found that dialysis patients had much thicker artery walls than people without kidney disease (1.60 mm vs. 0.80 mm). However, their artery stiffness measurements were similar to those of non-kidney disease patients. Although thicker artery walls (higher CIMT) appeared to predict cardiovascular events when looked at alone, this association disappeared once the researchers accounted for whether patients had diabetes. This suggests that diabetes — not CIMT itself — may be driving the elevated cardiovascular risk. Neither measure of arterial stiffness (PWV-BS or PWV-ES) was linked to heart disease events or death in the overall group. In a smaller analysis of only the 36 diabetic patients, a higher arterial stiffness measurement (left PWV-ES) was unexpectedly associated with fewer cardiovascular events, but the authors emphasize this finding should not be over-interpreted due to the small sample size and multiple statistical comparisons performed. This research suggests that commonly used artery health measurements may have limited standalone predictive value for dialysis patients, and that diabetes is a critical factor that needs to be considered when interpreting these measurements. The findings highlight the need for larger studies to determine which vascular measurements are truly useful for identifying dialysis patients at highest risk of heart disease, particularly among those with diabetes.
Zhu X, Zheng L, Zhang W, Liang X, Ren Y, Gu Q, et al.. (2026). Evaluation of carotid intima-media thickness and ultrafast pulse wave velocity for cardiovascular events and all-cause mortality in hemodialysis patients: impact of diabetes.. Renal failure. https://doi.org/10.1080/0886022X.2026.2723512