# CIMT en arteriële stijfheid voorspellen geen cardiovasculaire uitkomsten bij dialysepatiënten — prospectief cohort

*geplaatst 2026-09-10 · Nierziekte · Renal failure · doi 10.1080/0886022X.2026.2723512 · https://hartvaat.nl/2026/12/01/cimt-en-arteriele-stijfheid-voorspellen-geen-cardiovasculaire-uitkomsten-bij-dia/*

In een prospectief cohort van 115 dialysepatiënten werd onderzocht of carotide intima-media dikte (CIMT) en ultrafast pulse wave velocity (ufPWV) cardiovasculaire events en mortaliteit voorspellen. Hoewel CIMT in dialysepatiënten verhoogd was, verdween de associatie met cardiovasculaire uitkomsten na correctie voor diabetes (HR 1,35; p=0,186). Ook de PWV-metingen waren in de totale groep niet significant voorspellend. Een onderverdeling bij patiënten met diabetes toonde een hypothetisch verband tussen linker PWV-ES en cardiovasculaire events, maar dit is door de kleine steekproef en multiple toetsingen louter hypothesis-generating. De bevindingen onderstrepen de beperkte prognostische waarde van deze echografische markers in deze populatie en benadrukken de noodzaak van validatie in grotere cohorts.

## English: Evaluation of carotid intima-media thickness and ultrafast pulse wave velocity for cardiovascular events and all-cause mortality in hemodialysis patients: impact of diabetes.

A prospective cohort of 115 maintenance hemodialysis patients was evaluated for the prognostic value of carotid intima-media thickness (CIMT) and ultrafast pulse wave velocity (ufPWV) on cardiovascular events and mortality. Although CIMT was elevated in dialysis patients, its association with cardiovascular outcomes lost statistical significance after adjusting for diabetes (HR 1.35; p=0.186), and neither PWV parameter predicted outcomes in the overall cohort. A preliminary subgroup analysis in patients with diabetes suggested an inverse link between left PWV-ES and cardiovascular events, but this finding is hypothesis-generating due to the small sample size and multiple comparisons. Clinicians should interpret these arterial stiffness markers with caution in dialysis patients, as current evidence does not support their routine use for risk stratification without further validation in larger studies.

## Abstract (original, from the publication)

Arterial remodeling is common in end-stage renal disease (ESRD). This prospective cohort study explored the potential prognostic value of carotid intima-media thickness (CIMT) and ultrafast pulse wave velocity (ufPWV) - including pulse wave velocity at the beginning (PWV-BS) and end of systole (PWV-ES) for cardiovascular (CV) events and all-cause mortality in 115 maintenance hemodialysis (MHD) patients followed for 39 months. Compared with non-ESRD controls, MHD patients exhibited significantly higher CIMT (1.60 vs 0.80 mm, p = 0.004), while ufPWV parameters appeared comparable. During follow-up, 21 CV events and 17 deaths were recorded. In univariable analysis, CIMT was associated with CV events and positively correlated with diabetes (r = 0.271, p = 0.003). However, after adjusting for diabetes, this association was no longer statistically significant (HR 1.350, 95% CI 0.865-2.106, p = 0.186). Neither PWV-BS nor PWV-ES was associated with outcomes in the overall cohort. Preliminary subgroup analysis of patients with diabetes (n = 36, 15 CV events) observed an inverse association between left PWV-ES and CV events. In conclusion, 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 analyses performed within the overall MHD population. Given the issue of multiple comparisons and small sample size, the isolated finding between left PWV-ES and CV events in the diabetic subgroup must be treated strictly as hypothesis-generating, requiring independent validation in a larger cohort.

Auteurs: Xiaoye Zhu, Linna Zheng, Weibin Zhang, Xiaowan Liang, Yuan Ren, Qiaozhi Gu, Yuelin Zhang, Li You, Jun Xue, Chuanming Hao, Yuanhao Wu

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Bron: Renal failure, https://doi.org/10.1080/0886022X.2026.2723512. Bijgewerkt 2026-09-04T00:52:20Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.