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      Clinical Characteristics and Survival in End-Stage Renal Disease Patients with Arteriosclerosis obliterans

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          Background: Atherosclerotic disease (ASO) is considered a serious problem in dialysis patients. We tried to clarify the characteristics of ASO and to evaluate its impact on survival. Methods: Between January 1990 and December 1999, 525 patients with end-stage renal disease were admitted to our hospital. Among these patients, 71 (59 male and 12 female) had ASO. Blood pressure and blood samples were measured before and after hemodialysis, and were compared with the hemodialysis patients without any cardiovascular diseases. Mortality findings were collected until April 30, 2000. Results: Patients with ASO contained a larger percentage of males, hypertension, hyperlipidemia, diabetes mellitus, nephrosclerosis and smoking status. Their serum calcium, serum phosphate, triglyceride and C-reactive protein levels were also higher. During the follow-up period (2.8 ± 0.2 years), the mortality rate of the patients with ASO was higher than the hemodialysis patients without any cardiovascular diseases. Among the patients with ASO, the significant covariates concerning the cardiovascular mortality rate were age, hyperlipidemia and smoking status according to the Cox Proportional Hazards regression analysis. Conclusions: Hemodialysis patients with ASO had many traditional risk factors and uremic risk factors. Their survival rate was poorer and dependent on these risk factors.

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          Interaction between hypertension and other cardiovascular risk factors in survival of hemodialyzed patients.

          The interaction of hypertension with other cardiovascular risk factors, namely hypercholesterolemia, smoking, and past history of cardiovascular complications, was examined. One hundred and ninety-five hemodialysis patients were followed up for 54.2 +/- 2.3 months, among whom 66 died. In patients with cardiovascular complications, such as ischemic heart disease, cerebrovascular accident, or atherosclerotic obliteration of peripheral arteries, and in patients older than 70 years, blood pressure had no significant effect on the already poor survival. On the other hand, in patients with hypercholesterolemia (> or = 220 mg/dL) and in smokers, elevated systolic blood pressure made the survival significantly worse. These results suggest an interaction between hypertension and other cardiovascular risk factors in hemodialysis patients.

            Author and article information

            Am J Nephrol
            American Journal of Nephrology
            S. Karger AG
            December 2002
            07 October 2002
            : 22
            : 5-6
            : 422-428
            Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Osaka, Japan
            65267 Am J Nephrol 2002;22:422–428
            © 2002 S. Karger AG, Basel

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            Page count
            Figures: 1, Tables: 5, References: 20, Pages: 7
            Self URI (application/pdf):
            Clinical Study

            Cardiovascular Medicine, Nephrology

            Hemodialysis, Risk factor, Arteriosclerosis


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