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RENAL REPLASMAN TEDAVİSİ GÖREN HASTALARDA KORONER ARTER KALSİFİKASYONU

CORONARYARTERY CALCIFICATION IN PATIENTS UNDERGOING RENALREPLACEMENT THERAPIES

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: Cardiovascular disease (CVD) is a common cause of morbidity and mortality both in patients undergoing dialysis and in transplant recipients. The presence of calcified coronary lesions, as can be determined and quantified by electron-beam computed tomography (EBCT), is closely correlated with the extent and severity of angiographically documented atherosclerotic lesions. In the present study, coronary artery calcifications (CAC) were measured and compared in hemodialysis (HD) patients and in transplant recipients and their correlation with other patient characteristics was assesed. Materials and methods: Twenty-three (13 males, 10 females; mean age: 47.1±12.3 years) patients on chronic HD therapy and 15 (9 males, 6 females; mean age: 36.3±10.0 years) transplant recipients were included in the study. Traditional risk factors of CVD, serum calcium, phosphorus, and calcium-phosphorus ion product, duration of renal replacement therapy, and quantification of CAC were measured. Results: Chronic HD patients had significantly higher levels of age, serum phosphorus, serum calcium-phosphorus ion products, total cholesterol, CAC scores and had higher frequency of smoking compared to the transplant recipients. However, hypertension and serum HDL-cholesterol levels were significantly low in this group. Moreover, CAC scores correlated with serum phosphorus and calcium-phosphorus ion products (r=0.511, P=0.013) in HD patients. Conclusions: High CAC and elevated serum calcium-phosphorus product in the patients on chronic HD seems to be associated with the development of coronary artery calcification in these patients.
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Abstract (Original Language): 
Amaç: Diyalize giren ve renal transplantasyon geçiren hasta gruplar›nda kardiyovasküler hastal›klar mortalite ve morbiditenin en s›k nedenidir. Elektron-beam bilgisayarl› tomografi (EBBT) ile ölçülen kalsifiye koroner lezyonlar› anjiografik olarak belgelenmifl aterosklerotik lezyonlar›n fliddeti ve tutulumu ile koreledir. Bu çal›flmada hemodiyalize giren ve renal replasman geçiren hastalarda EBBT ile koroner arter kalsifikasyon skorunun (KAKS) saptanmas› ve KAKS de¤erlerinin hemodiyaliz ve transplantasyon gruplar› aras›nda karfl›laflt›r›lmas› ve di¤er hasta özellikleri ile korelasyonunun araflt›r›lmas› amaçland›. Gereç ve yöntem: Kronik hemodiyaliz tedavisinde olan 23 hasta (13 erkek, 10 kad›n; ortalama yafl: 47,1±12,3 y›l) ve renal replasman tedavisi uygulanm›fl 15 hasta (9 erkek, 6 kad›n; ortalama yafl: 36,3±10,0 y›l) çal›flmaya al›nd›. Kardiyovasküler hastal›klar için geleneksel risk faktörleri, serum kalsiyum, fosfor ve kalsiyum-fosfor çarp›m›, renal replasman tedavi süresi ve KAKS ölçüldü. Bulgular: Kronik hemodiyaliz hastalar›nda yafl, serum fosfor, kalsiyum-fosfor çarp›m›, total kolesterol, KAKS ve sigara kullananlar›n oran› renal replasman tedavisinde olanlardan anlaml› olarak daha yüksekti. Bununla birlikte, bu grupta hipertansif olanlar›n oran› ve serum HDL kolesterol düzeyi anlaml› olarak daha düflük saptand›. Yine hemodiyaliz hastalar›ndaki KAKS, serum fosfor ve kalsiyum-fosfor çarp›m› ile korele idi (r=0,511, P=0,013). Sonuç: Bu çal›flman›n sonuçlar›na göre kronik hemodiyaliz hastalar›nda koroner arter kalsifikasyon gelifliminden kalsiyum-fosfor çarp›m› yüksekli¤i sorumlu görünmektedir
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