ABSTRACT
BACKGROUND: Cardiovascular disease in chronic kidney disease (CKD) has peculiar characteristics. The aim of this study was to analyze atherosclerosis, vascular calcification and nitration in arteries from CKD patients. METHODS: External iliac and renal artery segments from 27 stage 5 CKD patients and 25 donor controls, respectively, were collected during the transplantation procedure. RESULTS: CKD patients presented a significantly higher degree of lesion. In a large proportion (72%) of CKD patients, we observed vascular calcifications. Immunohistochemistry for nitrotyrosine revealed a significant increase in nitrotyrosine production in arteries from CKD patients compared with control donors. In addition, within CKD patients, nitrotyrosine staining was significantly stronger in arteries with media calcification when compared with arteries without media calcification. CONCLUSION: The arteriopathy in the CKD patients appears in an early age and seems to be distinct from the arteriopathy of the general population, especially due to intense calcification and vascular oxidative stress.
Subject(s)
Kidney Failure, Chronic/metabolism , Kidney Failure, Chronic/pathology , Proteins/metabolism , Vascular Calcification/pathology , Adult , Atherosclerosis/pathology , Case-Control Studies , Female , Humans , Male , Middle Aged , Renal Artery/metabolism , Renal Artery/pathology , Risk Factors , Tyrosine/analogs & derivatives , Tyrosine/metabolismABSTRACT
Doenças cardiovasculares são as principais complicações fatais da doença renal crônica, tanto para pacientes em terapia renal substitutiva quanto para aqueles em tratamento conservador. A análise de seus fatores de risco, abordagem diagnóstica e adequado tratamento são fundamentais para a redução de mortalidade associada a essas complicações. Neste artigo de revisão são discutidos aspectos de fisiopatologia, métodos de investigação e abordagem terapêutica da doença cardiovascular na doença renal crônica.
Cardiovascular diseases are the major fatal complications of chronic kidney disease, both for patients in renal replacement therapy and for those on dialysis. The analysis of their risk factors, diagnosis and appropriate treatment are key to reducing mortality associated with these complications. In this review we discuss aspects of pathophysiology, research methods and therapeutic approach to cardiovascular disease in chronic kidney disease.
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Hypertrophy, Left Ventricular/complications , Uremia/complications , Health Evaluation/methodsABSTRACT
Cardiovascular disease is the leading cause of death in the set of chronic kidney disease (CKD) patients, whether on renal replacement therapy or conservative treatment. A better understanding of cardiovascular risk factors, diagnostic approach and management are central keys to develop strategies to reduce cardiovascular mortality among those patients. This review article discusses some aspects of pathophysiology, investigation methods and current treatment of cardiovascular disease in CKD patients.
Subject(s)
Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/therapy , Kidney Diseases/complications , Cardiovascular Diseases/etiology , Cardiovascular Diseases/physiopathology , Chronic Disease , Humans , Risk FactorsABSTRACT
The usual drug used in the Wada test is amobarbital, but it is not available in Brazil. Propofol was already used by Bazin et al. in 1998, and in their report the test resulted good in the absence of any adverse effect. We report the use of propofol as the anesthetic for the Wada test. The test was carried out in a 26 years old woman with temporal medial lobe epilepsy refractory to medical treatment. Language functions and memory were tested after injection in both hemispheres by three procedures (Seattle, Montreal and Interview procedures). Propofol showed to be good to carry on the Wada test.
