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Hemodiyaliz ve Periton Diyaliz Hastalarının Koroner Arter Kalsifikasyonu, Fetuin-A ve İnflamasyon Arasındaki İlişki

Relationship Between Fetuin-A, Inflammation, Coronary Artery Calcification in Hemodialysis and Peritoneal Dialysis Patients

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DOI: 
DOI 10.5262/tndt.2012.1002.02
Abstract (2. Language): 
OBJECTIVE : Vascular calcification is commonly seen in patients with end-stage renal disease (ESRD). Fetuin-A has been found to be a vascular calcification inhibitor and its level is significantly low in ESRD patients. The aim of our study was to investigate the relation between coronary artery calcification, inflammation and fetuin-A levels in peritoneal dialysis (PD) and hemodialysis (HD) patients. MATER IAL and Methods: 46 PD (M/F=28/18) and 34 (M/F=20/14) HD patients were included in the study. Coronary artery calcification scoring was made by multi slice computed tomography. PD and HD patients were divided into 2 groups according to their median CACS values Serum levels of fetuin-A, CRP, IL-6 and TNF-α are studied. Results : There were no differences in demographic features of PD and HD patients. There was a correlation between CACS, advanced age, dialysis vintage and fetuin-A. We could not find any correlation between inflammatory markers and CACS. There was a statistically significant difference between fetuin-A and CACS groups. Conc lusion : Age, duration of dialysis, fetuin-A levels were found to be related to CACS in PD and HD patients. Fetuin-A may play a role in increased mortality in this population via facilitating CACS.
Abstract (Original Language): 
Amaç : Son dönem böbrek yetersizliği (SDBY) gelişen hastalarda damarsal kalsifikasyon yaygın olarak gözlenmektedir. Fetuin-A, vasküler kalsifikasyon durdurucu olarak bulunmuş ve SDBY’li hastalarda serum fetuin-A düzeyinin ileri derecede düşük olduğu saptanmıştır. Çalışmamızın amacı periton diyaliz (PD) ve hemodiyaliz (HD) hastalarında koroner arter kalsifikasyonu (KAKS), inflamasyon ve Fetuin-A arasındaki ilişkiyi incelemektir. Gereç ve yöntemLER: Çalışmamıza 46 PD (E/K=28/18) ve 34 HD (E/K=20/14) hastası alınmıştır. Hastalara çoklu kesit alan bilgisayarlı tomografi ile koroner arter kalsiyum skorlaması yapıldı. PD ve HD hastaları medyan KAKS değerlerine göre olmak üzere 2 gruba ayrıldı. Serumda Fetuin-A, CRP, IL-6 ve TNF-α çalışıldı. Bulgular: HD ve PD hastalarında demografik veriler açısından bir fark yoktu. PD ve HD hastalarında yaş ve diyaliz süresi artıkça KAKS artıyordu. PD ve HD hastalarında fetuin-A ile KAKS arasında olumsuz ilişki bulundu. PD ve HD hastalarında, inflamatuvar belirteçler ile KAKS arasında ilişki bulunmadı. Fetuin-A ile KAKS grupları arasında istatistiksel olarak anlamlı ilişki saptandı. Son uç: PD ve HD hastalarında yaş, diyaliz süresi, fetuin-A düzeyi ve KAKS arasında ilişkili olduğu saptanmıştır. Bu populasyonda, fetuin-A, KAKS’ı arttırmak suretiyle mortaliteyi arttırıyor olabilir.
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