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HEMODİYALİZ HASTALARINDA STANDART HEPARIN İLE DÜŞÜK MOLEKÜL AĞIRLIKLI HEPARİNİN KAN LİPİD DÜZEYLERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

COMPARISON OF THE EFFECT OF MOLECULAR WEIGHT HEPARIN (LMWH) AND UNFRACTIONATED HEPARIN (UFH) ON PLASMA LIPOPROTEINS IN PATIENTS ON HEMODIALYSIS PATIENTS

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Abstract (2. Language): 
Patients undergoing maintenance hemodialysis therapy have increased mortality due to cardiovascu¬lar disease. One possible etiologic factor for this inc¬reased mortality are the lipid abnormalities associa¬ted with chronic renal failure. In this study the effects of low molecular weight heparin (LMWH) and con¬ventional unfractioned heparin (UFH) on plasma li-pids were investigated in hemodialysis patients. In a group of 10 patients who had been on chronic hemo-dialysis for longer than 20 months, UFH was repla¬ced by LMWH for 6 months. Baseline values of lipop-rotein profile prior to the intervention were compared with results obtained after 6 months of LMWH. Cont¬rol values were obtained 6 months after switching back to conventional heparin. During the LMWH tre¬atment total cholesterol, LDL-cholesterol and trigl-yceride levels decreased significantly. This coincided with a significant increase in HDL-cholesterol. After switching back again to conventional heparin, the li-poprotein parameters returned to starting values. We conclude that the long-term use of LMWH instead of conventional heparin for anticoagulation during di¬alysis may contribute to a reduction of the cardiovas¬cular risk factor of hemodialysis patients.
Abstract (Original Language): 
Hemodiyaliz uygulanan hastalarda kardiyovaskü-ler hastalıklara bağlı ölüm oranı oldukça yüksektir. Bunun nedenlerinden birisi de kronik böbrek yetmezli¬ği ile birlikte bulunan lipid metabolizması bozuklukla¬rıdır. Bu çalışmada hemodiyaliz hastalarında standart heparin (UFH) ile düşük molekül ağırlıklı heparin (LMWH)in kan lipid düzeylerine etkileri araştırıldı. 20 aydan uzun süredir UFH ile hemodiyaliz uygulanmakta olan 10 hastaya 6 ay süreyle LMWH verile¬rek, çalışmaya başlanmadan önceki bazal lipid pro¬filleri ile 6 ay sonunda elde edilen değerler karşılaş¬tırıldı. Bundan sonra tekrar 6 ay daha UFH tedavisi¬ne geri dönülerek kontrol değerleri oluşturuldu. LMWH tedavisi sırasında total kolesterol, LDL-koles-terol ve trigliserid düzeylerinde anlamlı düşüş, HDL-kolesterolde ise artış tespit edildi. Tekrar standart he-parin tedavisine başlandıktan sonra lipid profilleri başlangıç değerlerine geri döndü. Bu sonuçlara göre hemodiyalizde antikoagülasyon için standart heparin yerine LMWH'in uzun süre kullanımının kardiyovas-küler risk faktörlerini azaltabileceğini söyleyebiliriz.
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