ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Increased Carotid Artery Wall Lesions And Associated Variables In Hemodialysis Patients
Ahmet A. KIYKIM, MD,a Ahmet ÇAMSARI, MD,b Serkan KAHRAMAN, MD,c Mustafa ARICI, MD,cBülent ALTUN, MD,c Dilek ÇİÇEK, MD,b Yunus ERDEM, MD,c Ünal YASAVUL, MD,c Çetin TURGAN, MD,c Şali ÇAĞLAR, MD,c Aytekin OTO, MDd
Department of Internal Medicine, aDivision of Nephrology, bDivision of Cardiology, Mersin University School of Medicine, MERSİNDepartment of Internal Medicine, cDivision of Nephrology, dDepartment of Radiology, Hacettepe University School of Medicine, ANKARA
Objective: Atherosclerotic cardiovascular disease (CVD) is still the major cause of the morbidity and mortality in end-stage renal disease (ESRD) patients. However, the characteristics of major arterial changes, atherosclerosis and related risk factors in hemodialysis (HD) patients without symptomatic CVD remains unclear. The aim of the present study was to evaluate the atherosclerotic process in HD patients and to determine the association between the risk factors and the atherosclerotic process.
Material and Methods: Sixty-two HD patients [(female:27, male:35), (age: 42±13)] and age and sex matched 52 healthy volunteers [(female:23, male:29), (age: 39±9)] were enrolled in this study. Diabetics, smokers, and patients with symptomatic CVD were excluded. The right and left carotid intima-media thicknesses (CIMTs) were measured, and plaque structures were evaluated.
Results: The mean CIMT in patients and control group were 0.79±0.16 mm and 0.54±0.09 mm, respectively. Mean CIMT in HD patients was thicker (p<0.001) and the presence ratio of plaque was higher in the patient group (%61.2 vs %17.3, p<0.001). Calcified plaque type was more frequent in HD patients than control group (p<0.001). Age (r=0.48, p<0.001), left ventricular mass (r=0.42, p<0.05), homocysteine (r=0.46, p<0.01), haematocrit (r= -0.36, p<0.05), plasma CRP (r=0.50, p<0.001), ESR (r=0.43, p<0.01) and albumin (r= -0.34, p<0.05) levels were significantly correlated with CIMT measurements and plaque presence.
Conclusion: CIMT, as a putative atherosclerotic process indicator, appears to be thicker in HD patients than in healthy subjects. We concluded that, in addition to classical risk factors, an uremic environment may also contribute to acceleration in the atherosclerotic process.Keywords: Atherosclerosis, hemodialysis, carotis intimae-media thicknessTurkiye Klinikleri J Med Sci 2004, 24:17-25
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