International Urology and Nephrology

, Volume 48, Issue 10, pp 1713–1720 | Cite as

B-flow imaging estimation of carotid and femoral atherosclerotic plaques: vessel walls rheological damage or strong predictor of cardiovascular mortality in chronic dialysis patients

  • Petar AvramovskiEmail author
  • Maja Avramovska
  • Aleksandar Sikole
Nephrology - Original Paper



The aim of this study was to investigate the cardiovascular mortality in chronic hemodialysis patients (CHPs) and to discover the importance of carotid and femoral artery plaques as cardiovascular (CV) mortality predictor.


In this study with 4 years of follow-up period, we studied a cohort of 101 CHPs. Mean age at entry was 58.1 ± 11.9 years, and mean duration of dialysis was 5.8 ± 5.3 years. We performed B-flow imaging of both carotid and femoral arteries to estimate and score the plaque thickness.


The mean carotid and femoral plaque scores (PSs) at entry were 5.02 ± 4.20 and 4.04 ± 3.30 (p = 0.0002). The carotid cutoff point and femoral cutoff point (by ROC curves) were 5.4 and 5.9. The regression coefficients (b) and Exp (b) hazard ratio coefficients of carotid and femoral PS in Cox regression survival analysis in CV outcomes were: b = 0.142, Exp (b) = 1.153, p = 0.0035 versus b = 0.457, Exp (b) = 1.578, p < 0.0001. Relative hazard ratio (HR) risk of exposed group according to CV events was HR 2.812 (CI 1.301–6.081) for carotid PS and HR 2926 (CI 1.424–6.013) for femoral PS.


Carotid and femoral plaques are strong independent predictors of CV mortality in CHPs. The HR risk of femoral artery plaques is more predictable than HR risk of carotid artery plaques.


Carotid plaque Femoral plaque Chronic hemodialysis patients Cardiovascular mortality B-flow imaging 



There is no grant support or any acknowledgement. There is no disclose significant financial interests that he or she maintains (or members of their family maintain) with organizations or companies that might be affected by their research.

Compliance with ethical standards

Conflict of interest

Every one of the authors of this manuscript declares that they have not any conflict of interest. No potential conflict of interest relevant to this article was reported.

Ethical approval

All procedures in our studies and all human participants were in accordance with the ethical standards and our regional ethics committee approved the study. All participants give us informed and signed consent before including in the study.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  1. 1.Department of Internal MedicineJZU Clinical Hospital “D-r Trifun Panovski”BitolaRepublic of Macedonia
  2. 2.University Clinic of Obstetrics and GynecologyMedical Faculty “Ss. Cyril and Methodius University”SkopjeRepublic of Macedonia
  3. 3.University Clinic of NephrologyMedical Faculty “Ss. Cyril and Methodius University”SkopjeRepublic of Macedonia
  4. 4.High Medical SchoolSt. Clement of Ohrid UniversityBitolaRepublic of Macedonia
  5. 5.Faculty of Veterinary MedicineSt. Clement of Ohrid UniversityBitolaRepublic of Macedonia

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