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Hemodiyaliz Hastalarında Geleneksel ve Yeni Ateroskleroz Belirteçleri Arasındaki İlişki

The Relationship Between Traditional and New Atherosclerosis Indicators in Hemodialysis Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Cardiovascular disease based mortality levels in hemodialysis (HD) patients are high. The objective in this study was to investigate the relationship among traditional and newly described risk factors and carotid artery intima media thickness (CA-IMT) values in HD patients, and the contribution of HD duration to atherosclerosis development. Twenty-five patients (22 male, 3 female, age [years] 48.84±18.32, HD duration [months] 8.68±3.1) receiving HD treatment for less than 1 year, 25 patients (16 male, 9 female, age [years] 45.52±13.43, HD duration [months] 112.68±41.62) receiving HD for more than 5 years, and a control group (6 male, 4 female, age [years] 46±5.83) compatible with the patient group in terms of age and gender, were included in the study. Serum cholesterol, triglyceride, homocysteine, high-sensitivity C-reactive protein (HSCRP) levels, CA-IMT, carotid artery calcified plaque levels and mean arterial pressure (MAP) values were examined. Both CA-IMT (mm) and HSCRP (mg/dL) levels were determi¬ ned to be lower in the <1 year HD group (CA-IMT 0.62±0.14, HSCRP 1.07±0.89) than in the >5 year group (p = 0.04 and p = 0.04). Serum homocysteine (umol/L) levels were higher in the HD groups (16.6±8.5 for the <1 year group, 18.7±10.1 for the <5 year group) than in the control group (10.1±4.7), although the values for the 2 dialysis groups were similar. A positive correlation was observed in the HD groups between HSCRP and CA-IMT and carotid artery calcified plaque numbers. No significant difference in serum cho¬ lesterol, triglyceride or OAB levels was determined between the study groups. In conclusion, this study revealed a strong correlation among HSCRP and CA-IMT and carotid artery calcified plaque numbers in patients receiving HD treatment for <1 year and >5 years, and that HD duration may influence atherosclerosis development.
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Abstract (Original Language): 
Hemodiyaliz (HD) hastalarında kardiyovasküler hastalıklara bağlı mortalite sıklığı yüksektir. Bu çalışmada hemodiyaliz hastalarında geleneksel ve yeni tanımlanmış risk faktörleri ile karotis arter intima media kalınlığı (KA-İMK) ölçüm değerleri arasındaki ilişkinin ve hemodiyaliz süresinin ateroskleroz gelişimine katkısının araştı¬ rılması amaçlanmıştır. Çalışmaya bir yıldan az süre HD tedavisi gören 25 hasta (22 erkek, 3 kadın, yaş [yıl] 47.84±18.32, HD süresi [ay] 8.68+3.1), beş yıldan fazla HD tedavisi gören 25 hasta (16 erkek, 9 kadın, yaş [yıl] 45.52±13.43, HD süresi [ay] 112.68±41.62) ve hasta grubu ile yaş, cinsiyet uyumu olan 10 kişilik sağlıklı kontrol grubu (6 erkek, 4 kadın, yaş [yıl] 46±5.83) alındı. Çalışma gruplarında serum kolesterol, trigliserid, homosistein, high sensitivity C-reactive protein (HSCRP) düzeyleri, KA-İMK, karotis arter kalsifiye plak sayısı, ortalama arter basıncı (OAB) değerleri incelenmiştir. Gerek KA-İMK (mm) ve gerekse HSCRP (mg/dL) düzeyleri <1 yıl HD yapılan grupta (KA-İMK 0.62±0.14, HSCRP 1.07±0.89) >5 yıl HD yapılan gruba (KA-İMK 0.71±0.12, HSCRP 1.69±1.17) göre daha düşük bulundu (p=0.04 ve p=0.04). Serum homosistein (umol/L) düzeyleri HD gruplarında (<1 yıl HD yapılan grup için 16.6±8.5, >5 yıl HD yapılan grup için 18.7±10.1) kontrol grubuna (10.1±4.7) göre yüksek (p=0.01 ve p=0.001) olmakla birlikte iki diyaliz grubunun değerleri birbirinden farklı değildi (p>0.05). HD gruplarında HSCRP'nin KA-İMK ve karotis arter kalsifiye plak sayısı ile pozitif ko¬ relasyonu olduğu görüldü. Serum kolesterol, trigliserid düzeyleri, OAB değerlerine göre çalışma grupları arasında anlamlı fark bulun¬ madı. Sonuç olarak, bu çalışmada <1 yıl ve >5 yıl süreyle hemodiya¬ liz tedavisi gören hastalarda HSCRP ile KA-İMK ve karotis arter kalsifiye plak sayısı arasında kuvvetli bir ilişki olduğu, hemodiyaliz sü¬ resinin ateroskleroz gelişiminde etkili olabileceği ortaya kondu.
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36
Türk
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