Jakovljevic Biljana, Gasic Branislav, Kovacevic Pedja, Rajkovaca Zvezdana, Kovacevic Tijana
International Dialysis Center Banjaluka, DC Laktasi, Bosnia and Herzegovina.
Nephrology Department, University Hospital Clinical Center Banjaluka, Banjaluka, Bosnia and Herzegovina.
Mater Sociomed. 2015 Apr;27(2):95-8. doi: 10.5455/msm.2015.27.95-98. Epub 2015 Apr 5.
Cardiovascular diseases are leading cause of death in patients with chronic renal failure. The aim of our study was to establish connection between levels of homocysteine and traditional and nontraditional risk factors for developing cardiovascular diseases in dialysis and pre dialysis patients.
We included 33 pre dialysis (23 in stage three and 10 in stage four of chronic kidney disease) and 43 patients receiving hemodialysis longer than six months. Besides standard laboratory parameters, levels of homocysteine and blood pressure were measured in all patients. Glomerular filtration rate was measured in pre dialysis patients and dialysis quality parameters in dialysis patients.
Homocysteine levels were elevated in all patients (19±5.42mmol/l). The connection between homocysteine levels and other cardiovascular diseases risk factors was not established in pre dialysis patients. In patients treated with hemodialysis we found negative correlation between homocysteine levels and patients' age (p<0.05) and positive correlation between homocysteine levels and length of dialysis (p<0.01) as well as between homocysteine and anemia parameters (erythrocytes, hemoglobin), (p<0.01). Homocysteine and LDL (and total cholesterol) were in negative correlation (p<0.01).
Homocysteine, as one of nontraditional cardiovascular diseases risk factors, is elevated in all patients with chronic renal failure and it's positive correlation with some other risk factors was found.
心血管疾病是慢性肾衰竭患者的主要死因。我们研究的目的是确定同型半胱氨酸水平与透析及透析前患者发生心血管疾病的传统和非传统危险因素之间的联系。
我们纳入了33例透析前患者(23例处于慢性肾脏病三期,10例处于四期)和43例接受血液透析超过6个月的患者。除了标准实验室参数外,还测量了所有患者的同型半胱氨酸水平和血压。对透析前患者测量了肾小球滤过率,对透析患者测量了透析质量参数。
所有患者的同型半胱氨酸水平均升高(19±5.42mmol/l)。在透析前患者中未发现同型半胱氨酸水平与其他心血管疾病危险因素之间的联系。在接受血液透析的患者中,我们发现同型半胱氨酸水平与患者年龄呈负相关(p<0.05),与透析时间呈正相关(p<0.01),与贫血参数(红细胞、血红蛋白)也呈正相关(p<0.01)。同型半胱氨酸与低密度脂蛋白(及总胆固醇)呈负相关(p<0.01)。
同型半胱氨酸作为非传统心血管疾病危险因素之一,在所有慢性肾衰竭患者中均升高,且发现其与其他一些危险因素呈正相关。