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Hemodiyaliz ve Periton Diyaliz Hastalarında Fetuin-A Seviyeleri ile Karotis İntima Media Kalınlığı ve Valvuler Kalsifikasyon Arasındaki İlişki

Association of Fetuin-A Levels with Carotid Intima Media Thickness and Valvular Calcification in Hemodialysis and Peritoneal Dialysis Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
DOI 10.5262/tndt.2013.1001.07

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Backgro und: Fetuin-A is a negative acute-phase reactant which prevents vascular calcification. Coronary artery disease (CAD) is the most important cause of mortality in patients undergoing renal replacement therapy (RRT). The key element of cardiovascular disease (CVD) seen in end-stage renal disease patients who are on dialysis treatment is accelerated calcific atherosclerosis. There are a limited number of studies in which HD and PD is compared in terms of fetuin-A level. OBJECTIVE: We aimed to investigate the association of serum fetuin-A level with valvular calcification and predictors of CAD in hemodialysis (HD) and peritoneal dialysis (PD) patients. MA TERIAL and M ETHODS: 39 HD (24 males, 15 females) and 39 PD (25 males, 14 females) patients were included in the study. We determined carotid artery intima media thickness (CIMT) and evaluated heart valve calcification via echocardiography. We also measured serum fetuin-A level, CRP, ferritin, fibrinogen and serum albumin level. According to fetuin-A level, patients were stratified into quartiles. RESUL TS: Fetuin-A level was significantly lower in HD patients when compared with that of PD patients (28.6±5.934 ng/ml, 32±4.8 ng/ml respectively p<0.001). There was a significant negative correlation between CIMT and fetuin-A level. CIMT was found to be lower in PD patients than in HD patients. We found a positive correlation between fetuin-A and dialysis adequacy and albumin level. There was a negative correlation of fetuin-A with age, fibrinogen, ferritin and CRP. Fetuin-A level was lower in patients with aortic calcification. ConclusIo n: Fetuin-A level was found to be lower in HD patients. Fetuin-A may be a novel marker for CVD in patients undergoing RRT.
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Abstract (Original Language): 
GİRİŞ: Fetuin A vasküler kalsifikasyonu önleyen bir negatif akut faz reaktanıdır. Koroner arter hastalığı (KAH) renal replasman tedavisi almakta olan hastalarda en önemli ölüm sebebidir. Diyalize giren son dönem böbrek yetmezliği hastalarında görülen kardiyovasküler hastalığın ana elementi hızlanmış kalsifik aterosklerozdur. Fetuin A seviyeleri açısından hemodiyaliz (HD) ve periton diyalizini(PD) karşılaştıran sınırlı sayıda çalışma mevcuttur. AMA Ç: HD ve PD hastalarında KAH prediktörleri ve valvüler kalsifikasyon ile serum fetuin A düzeyleri arasındaki ilişkiyi araştırmayı amaçladık. GEREÇ ve YÖN TEML ER: 39 HD (24 erkek, 15 kadın) ve 39 PD (25 erkek, 14 kadın) hastası çalışmaya alındı. Karotis intima media kalınlığı (KIMK) ultrason ile ölçüldü ve kalp kapağı kalsifikasyonları ekokardiyografi ile değerlendirildi. Ayrıca serum fetuin-A, CRP, ferritin, fibrinojen, ve albumin seviyeleri saptandı. Fetuin-A düzeylerine göre hastalar çeyreklere ayrıldı. Bulgular: Fetuin-A seviyesi HD hastalarında PD hastalarına göre daha düşüktü (hemodiyaliz 28,6±5,934 ng/ml, PD 32±4,8 ng/ml, p<0,001). KIMK ile fetuin-A seviyesi arasında anlamlı negatif korelasyon vardı. KIMK, PD hastalarında HD’e göre daha düşüktü. Fetuin-A seviyesi ile diyaliz yeterliliği ve albumin arasında pozitif korelasyon saptanırken fetuin-A ile yaş, fibrinojen, ferritin ve CRP arasında negatif korelasyon saptandı. Fetuin-A düzeyi aortik kalsifikasyonu olanlarda daha düşüktü (p<0.05). Sonuç: Fetuin-A seviyesi HD hastalarında daha düşük olarak saptandı. KAH prediktörleri ile ilişkisi düşünüldüğünde RRT almakta olan hastalarda özellikle HD hastalarında KVH için yeni bir belirteç olabilir.
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