Profile of Carotid Artery Ultrasound in Chronic Kidney Disease (CKD) Patients Undergoing Hemodialysis at Dr. Soetomo General Hospital, Surabaya

Abstract

Chronic Kidney Disease (CKD) is recognized as a major contributor to global mortality. The Global Burden of Disease (GBD) 2017 report placed CKD as the 12th leading cause of death worldwide, with projections elevating it to the 5th position by 2040. Disruptions in calcium and phosphate regulation in CKD patients lead to vascular structural and functional abnormalities, promoting early arterial calcification and plaque formation. This research seeks to characterize the ultrasound findings of the common carotid artery and extracranial internal carotid artery in CKD patients receiving hemodialysis at Dr. Soetomo General Hospital, Surabaya. A descriptive observational method was utilized, collecting data through carotid artery ultrasound scans in CKD patients undergoing hemodialysis at the hospital from May to June 2025. Demographic data, laboratory and radiological examination results were taken from medical records according to the subject's current condition. The results of the study showed that patients with Chronic Kidney Disease (CKD) undergoing hemodialysis at Dr. Soetomo General Hospital were mostly female (55.8%). Of the 43 subjects, most were aged 41-60 years (72.1%) with a duration of hemodialysis ranging from 1-10 years (93.1%). Most of the subjects involved in this study were non-smokers (67.4%) and the most common etiology of the disease causing hemodialysis was hypertension (53.5%) followed by toxic nephropathy (25.6%). The majority had a normal body mass index (53.5%), normal calcium and phosphate levels (58.1% and 41.9%) followed by hypocalcemia (34.9%) and hyperphosphatemia (32.6%). Most subjects had normal triglyceride levels (67.4%), normal HDL levels (51.2%), and normal LDL levels (83.7%), and the group that experienced a significant increase in triglycerides (32.6%). The majority of subjects also had normal albumin levels (90.7%), and hypoalbuminemia was found in 9.3%. Carotid ultrasound examination found an 18.6% increase in carotid intima-media thickness (cIMT) and plaque in 60.5% of subjects. The most common location of plaque formation was in the carotid bulb followed by the distal common carotid artery, with most plaques having hyperechoic echogenicity (95.8%), where 100% of the plaques found caused stenosis of <50% of the arterial lumen.