Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições? / Cardiac evaluation of patients with chronic kidney disease: what lessons?
J. bras. nefrol
;
34(1): 8-15, jan.-fev.-mar. 2012. tab
Article
in Portuguese
| LILACS
| ID: lil-623349
RESUMO
INTRODUÇÃO:
Pacientes com doença renal crônica (DRC) apresentam sinergismo entre fatores de risco tradicionais para aterosclerose e emergentes derivados do estado urêmico.OBJETIVO:
Traçar o perfil epidemiológico de um grupo de pacientes com DRC submetido à avaliação cardiológica.MÉTODOS:
Pacientes sintomáticos - com isquemia em cintilografia miocárdica e/ou disfunção sistólica ao ecodopplercardiograma - com idade maior que 50 anos e diabetes mellitus (DM) como causa da DRC e aqueles com dois ou mais fatores de risco ateroscleróticos realizaram cineangiocoronariografia. Assintomáticos - não diabéticos e sem fatores de risco - foram investigados com ecodopplercardiograma e aqueles com único fator de risco, por meio de ecodopplercardiograma e cintilografia.RESULTADOS:
Foram estudados 46 pacientes, 58,7% homens, idade de 50-70 ± 11,7 anos, 91,3% dialíticos. Tempo de hemodiálise 61,96 ± 55,1 meses. Hipertensão arterial foi causa da DRC em 56,5%. Dos 28 pacientes (60,9%) submetidos à cineangiocoronariografia, 53,6% apresentaram doença arterial coronariana (DAC). Os pacientes foram divididos em três grupos com DAC (A), sem DAC (B) e não submetidos à cineangiocoronariografia (C). Diferença significativa ocorreu entre os Grupos B e C na frequência de índice tibiobraquial (ITB) anormal (p = 0,026), com ausência de ITB anormal no Grupo C e na média de idade, superior no B (p = 0,045). No Grupo A, 53,3% dos pacientes estavam em avaliação pré-paratireoidectomia (PTX).CONCLUSÃO:
Este estudo confirmou a alta frequência de alterações cardiovasculares, inclusive de DAC, nos pacientes portadores de DRC, principalmente naqueles em diálise.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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Renal Insufficiency, Chronic
/
Heart Diseases
Type of study:
Etiology study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
Portuguese
Journal:
J. bras. nefrol
Journal subject:
Nephrology
Year:
2012
Type:
Article
Affiliation country:
Brazil
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