Vessel wall alterations in patients with renal failure

Cardiovascular complications are a major cause of morbidity and mortality i n patients with renal failure. Death due to myocardial infarction and to st roke is more frequent in hemodialysis patients than in the total population . These cardiovascular diseases are mainly the consequence of atheroscleros is and cause decreased life expectancy in patients with renal failure. Ultr asound techniques now make it possible to measure atherosclerotic lesions i n big acid medium-sized arteries. Thickening of the intima-media-complex is an early sign of atherosclerosis in these vessels. It reduces the distensi bility of the arteries during systole, The distensibility of big and medium -sized arteries can be determined using ultrasound-doppler-techniques, In o ur studies, the intima-media-thickness of the carotid artery was significan tly (p < 0.01) increased in patients with chronic renal failure (1.32+/-0.4 9 mm, n=28) as compared with aged-matched healthy control subjects (0.75+/- 0.20, n=29). The distensibility coefficient was higher (p < 0.05) in health y controls (26+/-1.8 10(-3)/kPa, n=12) than in patients with renal insuffic iency (19+/-1.7 10(-3)/kPa, n=12). This demonstrates increased stiffness of the vessel wall resulting in loss of Windkessel function and increased wor k load of the heart.