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KBY’li Hastalarda, Farklı Hipertansif Tedavi Yöntemlerinin Endotelyal Fonksiyonlara Olan Etkisinin Biyokimyasal Parametrelerle İncelenmesi

The Effect of Different Antihypertensive Treatment Methods on Endothelial Functions in Patients With Chronic Renal Failure on Hemodialysis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2010
DOI: 
10.5262/tndt.2010.1001.02

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Hypervolemia and uremic toxins result in accelerated atherosclerosis in chronic renal failure by causing endothelial dysfunction hypertension. The vast majority of patients undergoing renal replacement therapy are hypertensive and hypervolemic. It is accepted that these two risk factors are the most important causes of mortality. While five-year survival in hemodialysis patients using antihypertensive drugs is 40-50%, ten-year survival in hemodialysis patients applied strict volume control is 70%. MATERIAL and Method: The study was composed of three groups as follows: control group (n=30), hemodialysis patients (normotensive with hypotensive drugs HDdrug, n=30), hemodialysis patients (normotensive with strict volume control HDvc, n=30). von Willebrand factor (vWF), D-dimer, nitric oxide (NO), homocysteine and routine biochemical parameters were studied in all groups. Result s: Although the interdialytic weight gain of the hemodialysis patients using antihypertensive drugs was higher than hemodialysis patients applied strict volume control (p<0.001), the blood pressure of the drug users was within the acceptable levels. However, the levels of vWF, and, D–dimer in patients applied volume control were lower than that of HDdrug. Conclusion: In conclusion, although antihypertensive drugs can decrease elevated blood pressure to a limited extent in dialysis patients, they cannot improve the endothelial dysfunction. Elevated blood pressure and endothelial dysfunction are controlled effectively with volume control.
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Abstract (Original Language): 
Kronik böbrek yetmezliğinde hipertansiyon, hipervolemi ve üremik toksinler endotel disfonksiyonuna neden olarak hızlanmış ateroskleroza yol açmaktadır. Renal replasman tedavisi almakta olan kronik böbrek yetmezlikli hastaların büyük çoğunluğu hipertansif ve hipervolemiktir. Bu iki risk faktörü en önemli mortalite nedeni olarak kabul edilmektedir. Antihipertansif ilaç alarak normotansif hale gelen hastalarda beş yıllık yaşam beklentisi %40-50’lerde iken, sıkı volüm kontrolüyle normotansiyon sağlananlarda ise on yıllık yaşam beklentisi %70’lere çıkmaktadır. GEREÇ ve yöntem: Çalışma grupları, kontrol grubu (n=30), hemodiyalize giren ve sıkı volüm kontrolü uygulanarak normotansif olan hasta grubu (HDvk) (n=30) ve hemodiyalize giren ve antihipertansif ilaç kullanarak normotansif olan hasta grubu (HDilaç) (n=30) şeklinde oluşturuldu. Tüm gruplarda, von Willebrand factor (VWF), D-Dimer, nitrik oksit (NO), homosistein ve rutin biyokimya parametrelerine bakıldı. Bulgular: HDilaç grubunun iki diyaliz arası kilo alımı, HDvk uygulanan gruba göre anlamlı olarak yüksek olmasına rağmen (p<0,001), HDilaç’ın tansiyonu kabul edilebilir değerler içindeydi. Ancak, vWf düzeyi ve D-dimer düzeyleri HDvk uygulanan hemodiyaliz hastalarında, HDilaç uygulanan hastalara göre düşük düzeydeydi. Sonuç: Sonuç olarak, diyaliz hastalarında yüksek kan basıncını antihipertansif ilaçlarla tedavi etmeye çalışmak, bozuk olan endotel fonksiyonlarını düzeltmemektedir. Sıkı volüm kontrolüyle, hastaların hipertansiyonları daha iyi kontrol altına alınabilirken, endotel fonksiyonları da oldukça iyi korunabilmektedir.
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  • 1
17-22
  • Turkish

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Günal (Yeşil) S ve ark: KBY’li Hastalarda, Farklı Hipertansif Tedavi Yöntemlerinin
Endotelyal Fonksiyonlara Olan Etkisinin Biyokimyasal Parametrelerle İncelenmesi
Cilt/Vol: 19, No: 1, 2010, Sayfa/Page: 17-22
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
Turkish Nephrology, Dialysis and Transplantation Journal
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
Turkish Nephrology, Dialysis and Transplantation Journal
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