Vol.12, No 1, 2005 pp. 28 - 32
UC 616.61-089.843:616.12-084
CARDIOVASCULAR RISK FACTORS AND
ECHOCARDIOGRAPHIC
FINDINGS IN PATIENTS ON WAITING LIST
FOR CADAVERIC KIDNEY TRANSPLANTATION
Goran J. Paunović1, Karolina
Paunović1,
Svetislav M. Kostić1,
Sonja Šalinger2, Goran Marjanović3,
Svetlana Apostolović2
1
Institute for Nephrology and Hemodialysis
2
Clinic for Cardiovascular Diseases
3
Clinic for Hematology, Clinical Center, Niš, Serbia and Montenegro
Summary. Cardiovascular (CV) disease is the main cause of
morbidity
and mortality in dialysis patients, as well as in the kidney transplant
recipient population. Assessing the prevalence of CV diseases and CV
risk
factors is an essential step in developing risk profiles and
individualizing
interventions to reduce the cardiovascular morbidity and mortality of
kidney
transplant recipients. Evaluating the CV organs of cadaveric kidney
transplant
potential recipients on the waiting list is very important for
prevention
of developing the post-transplant CV diseases.
The aim of this study was to determine prevalence of CV diseases and
risk factors of patients registered on the waiting list.
We performed a retrospective study on patients (pts) registered as
waiting for cadaveric kidney transplantation and evaluated their CV
status
concerning the ECG abnormality and echocardiographic finding. We also
discussed
CV risk factors in this population.
During the period October 2000-November 2003, 96 potential recipients
(42 females, 54 males) were evaluated for cadaveric kidney
transplantation
at the Institute for Nephrology and Hemodialysis, Clinical Center-Niš.
All the patients had sinus ritham, with no registered extra-systole and
no conduction abnormality in ECG. 67 pts (69.4%) had EF >50%. The
main
echocardiography characteristics were left ventricular hypertrophy
(LVH)
observed in 55 pts (56.9%) and LVH with left ventricular dilatations
(LVD)
observed in 21 pts (22.2%). Arterial hypertension, hyperlipidemia,
smoking
and, particularly, anemia were the most frequent risk factors among the
dialysis population.
Dialysis doctors should attempt at providing optimal diagnostic
procedures
and treatment for CV diseases and CV risk factors, even if this
generally
fails to prevent the CV diseases. Recognition of CV diseases, CV risk
factors,
and their treatment is essential for better post-transplant surviving
in
the kidney transplant recipient population.
Key words: Cardiovascular disease, dialysis, echocardiography,
left ventricular hypertrophy, kidney transplantation, hypertension
KARDIOVASKULARNI FAKTORI RIZIKA ZA
NASTAJANJE
OBOLENJA
SRCA I EHOKARDIOGRAFSKI NALAZ KOD BOLESNIKA
NA LISTI ČEKANJA
ZA KADAVERIČNU TRANSPLANTACIJU BUBREGA
Kratak sadržaj: Kardivaskularne bolesti su najčešći uzrok
smrtnosti
i obolevanja u populaciji bolesnika koji se leče ponavljanim
dijalizama.
Veoma slične rezultate vidimo i u studijama koji se bave morbiditetim i
mortalitetom bolesnika kod kojih je presadjen bubreg. Pažljivo
ispitivanje
stanja kardivaskularnog sistema potencijalnih recipijenata kadaveričnog
bubrega od velike je važnosti u prevenciji razvoja postransplantacionih
kardiovaskularnih bolesti.
Cilj rada je da se odredi prevalenca kardiovaskularnih bolesti kod
bolesnika na listi čekanja za kadaveričnu transplantaciju bubrega.
Uradili smo retrospektivnu studiju kod bolesnika sa liste čekanja za
kadaveričnu transplantaciju i odredili kardiovaskularni status u odnosu
na EKG promene i ehokardiografski nalaz. Takodje smo ispitivali
najvažnije
faktore rizika za nastajanje kardiovaskularnih bolesti.
U vremenskom periodu od oktobra 2000. do novembra 2003. godine ispitali
smi 96 potencijalnih recipijenata (?:?=42 bol.: 54 bol.)
kadaveričnog
bubrega u Institutu za nefrologiju i hemodijalizu u Nišu. Kod ove grupe
bolesnika nismo registrovali značajnije EKG promene. Najznačajnija
ehokardiografska
promena bila je hipertrofija leve komore koju smo našli kod 55
bolesnika
(56,9%), a sledi dilatacija leve komore kod 21 bolesnika (22,2%).
Ejekciona
frakcija iznad 50% nadjena je kod 67 bolesnika (69,4%). Arterijska
hipertenzija,
hiperlipidemija, pušenje, a pogotovo sekundarna anemija su
najznačajniji
faktori rizika kod ove populacije bolesnika.
U toku dijaliznog perioda bolesnicima koji se nalaze na listi čekanja
neophodno je obezbediti optimalni dijagnostički i terapijski pristup
koji
bi obezbedio prevenciju kardiovaskularnih bolesti. Takvim pristupom bi
sigurno obezbedili bolje preživljavanje u posttransplantacionom
periodu.
Ključne reči: Kardiovaskularne bolesti, dijaliza,
ehokardiografija,
hipertrofija leve komore, transplantacija bubrega, arterijska
hipertenzija
