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  • Title: Cardiac evaluation of patients with chronic kidney disease: what lessons?
    Author: Lordsleem A, Gueiros AP, Gueiros JE, Markman Filho B, Victor EG.
    Journal: J Bras Nefrol; 2012 Mar; 34(1):8-15. PubMed ID: 22441176.
    Abstract:
    INTRODUCTION: Patients with chronic kidney disease (CKD) experiment a synergistic effect of the traditional and the emerging uremia-related risk factors for atherosclerosis. OBJECTIVE: Draw the epidemiologic profile of a group of CKD patients who underwent cardiac evaluation. METHODS: Symptomatic patients, patients with ischemia on myocardial scintigraphy and/or systolic dysfunction on echocardiography, patients older than 50 years and diabetes mellitus (DM) as a cause of CKD, and those with two or more risk factors underwent coronary angiography. Asymptomatic, non-diabetic patients and patients with no risk factors were investigated with echocardiography. Those with a single risk factor were investigated with echocardiography and scintigraphy. RESULTS: 46 patients (58.7% men) were enrolled. Their mean age was 50.7 ± 11.7 years. 91.3% were on dialysis, for 61.96 ± 55.1 months. Hypertension was the cause of CKD in 56.5%. Of the 28 patients (60.9%) who underwent angiography, 53.6% had coronary artery disease (CAD). The patients were divided into three groups: those with CAD (A), those without CAD (B) and those who didn't undergo coronary angiography (C). A significant difference occurred only between groups B and C, as regards an abnormal ABI (p = 0.026), with no ABI abnormality in group C, and as regards the mean age, which was higher in group B (p = 0.045). In group A, 53.3% of the patients were in the preoperative stage of parathyroidectomy. CONCLUSION: This study confirmed the high rate of cardiovascular disorders, including CAD, in patients with CKD, especially those on dialysis.
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