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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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REFERENCES

References: 

1. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte
M Jr, Detrano R. Quantification of coronary artery calcium using
ultrafast computed tomography. J Am Coll Cardiol 1990;
15:827-832.
2. Braun J, Oldendorf M, Moshage W, Heidler R, Zeitler E, Luft
FC. Electron beam computed tomography in the evaluation of
cardiac calfications in chronic dialysis patients. Am J Kidney Dis
1996; 27:394-401.
3. Ehrlich JE, Rumberger JA. Detection and clinical management
of cardiovascular calcification in ESRD: A review. Dialysis
Transplant 2004; 33:306-316.
4. Friedman JA, Dwyer JT. Hyperhomocysteinemia as a risk factor
for cardiovascular disease in patients undergoing hemodialysis.
Nutrition Reviews 1995; 53:197-201.
5. Ghods AJ, Ossareh S. Detection and treatment of coronary artery
disease in renal transplantation candidates. Transplant Proceed
2002; 34:2415-2417.
6. Goldsmith DJA, Covic A. Coronary artery disease in uremia:
Etiology, diagnosis, and therapy. Kidney Int 2001; 60:2059-
2078.
7. Goodman WG, Goldin J, Kutzon ED, Yoon C, Gales B, Sider D,
Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky
IB. Coronary-artery calcification in young adults with end-stage
renal disease who are undergoing dialysis. N Eng J Med 2000;
342:1478-1482.
8. Gradaus F, Ivens K, Peters AJ, Heering P, Schoebel FC, Granbensee
B, Strauer BE. Angiographic progression of coronary artery
disease in patients with end-stage renal disease. Nephrol Dial
Transplant 2001; 16:1198-1202.
9. Haydar AA, Hujairi NM, Covic AA, Pereira D, Rubens M,
Goldsmith DJ. Coronary artery calcification is related to coronary
atherosclerosis in chronic renal disease patients: A study
comparing EBCT-generated coronary artery calcium scores and
coronary angiography. Nephrol Dial Transplant 2004; 19:2307-
2312.
10. Hujairi N, Afzali B, Goldsmith D. Cardiac calcification in renal
patients: What we do and don't know. Am J Kidney Dis 2004;
43:234-243.
11. Moe SM, O'Neill KD, Fineberg N, Persohn S, Ahmed S, Garrett
P, Meyer CA. Assessment of vascular calcification in ESRD patients
using spiral CT. Nephrol Dial Transplant 2003; 18:1152-
1158.
12. Nallamothu BK, Saint S, Bielak LF, Sonnad SS, Peyser PA, Rubenfire
M, Fendrick AM. Electron-beam computed tomography
in the diagnosis of coronary artery disease. Arch Intern Med
2001; 161:833-838.
13. Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U,
Mehls O, Schaefer F. Advanced Coronary and Carotid Arteriopathy
in Young Adults With Childhood-Onset Chronic Renal
Failure. Circulation 2002; 106:100-105.
14. Patel AD, Abo-Auda WS, Davis JM, Zoghbi GJ, Deierhoi MH,
Heo J, Iskandrian AE. Prognostic value of myocardial perfusion
imaging in predicting outcome after renal transplantation. Am J
Cardiol 2003; 92:146-151.
15. Raggi P. The use of electron-beam computed tomography as a tool
for primary prevention. Am J Cardiol 2001; 88:28-32.
16. Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke
SK, Chertow GM. Cardiac calcification in adult hemodialysis
patients. A link between end-stage renal disease and
cardiovascular disease? J Am Coll Cardiol 2002; 39:695-
701.
17. Raggi P, Cooil B, Hadi A, Friede G. Predictors of aortic and coronary
artery calcium on a screening electron beam tomographic
scan. Am J Cardiol 2003; 1:744-746.
18. Tamashiro M, Iseki K, Sunagawa O, Inoue T, Higa S, Afuso
H, Fukiyama K. Significant association between the progression
of coronary artery calcification and dyslipidemia in patients
on chronic hemodialysis. Am J Kidney Dis 2001; 8:4-
9.
19. Thomson LEJ, Hachamovitch R. Coronary artery calcium scoring
using electron-beam computed tomography: Where does
this test fit into a clinical practice? Rev Cardiovasc Med 2002;
3:121-128.
20. Yildiz A, Tepe S, Oflaz H, Yazici H, Pusuroglu H, Besler M, Ark
E, Erzengin F. Carotid atherosclerosis is a predictor of coronary
calcification in chronic haemodialysis patients. Nephrol Dial
Transplant 2004; 19:885-891.

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