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血液透析和腹膜透析患者心血管疾病危险因素的比较。

Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients.

作者信息

Harmankaya Ozlem, Akalin Nilgul, Akay Hatice, Okuturlar Yildiz, Erturk Kayhan, Kaptanogullari Hakan, Kocoglu Hakan

机构信息

Division of Nephrology, Bakırköy Dr. Sadi Konuk Teaching Hospital, Istanbul, TR.

Department of Dialysis Tecniciant, Biruni University, Istanbul, TR.

出版信息

Clinics (Sao Paulo). 2015 Sep;70(9):601-5. doi: 10.6061/clinics/2015(09)01.

Abstract

OBJECTIVE

In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.

METHODS

Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student's t test, the chi-square test and the Mann-Whitney U test, as appropriate.

RESULTS

No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).

CONCLUSION

In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients.

摘要

目的

在本研究中,我们旨在比较血液透析和腹膜透析患者中可能与炎症、动脉粥样硬化和代谢综合征相关的心血管危险因素。

方法

本研究纳入了50例接受血液透析和50例接受腹膜透析且已接受透析治疗至少一年的患者。空腹12小时后采集静脉血样,测量血清葡萄糖、甘油三酯、低密度脂蛋白(LDL)胆固醇、高密度脂蛋白(HDL)胆固醇、C反应蛋白、纤维蛋白原和同型半胱氨酸水平。通过颈动脉多普勒超声评估颈动脉粥样硬化斑块的存在情况。这些数据根据情况采用学生t检验、卡方检验和曼-惠特尼U检验进行分析。

结果

血液透析组(n = 50)和腹膜透析组(n = 50)在平均年龄、性别分布、体重指数或透析时长方面未发现差异(分别为p = 0.269、0.683、0.426和0.052)。腹膜透析患者的LDL胆固醇、纤维蛋白原和同型半胱氨酸水平显著更高(分别为p = 0.006、0.001和0.002)。在接受肾脏替代治疗的糖尿病患者(n = 17)中,LDL胆固醇和纤维蛋白原水平显著高于未患糖尿病且接受肾脏替代治疗的患者(分别为p = 0.001和0.004)。

结论

在我们的研究中,腹膜透析患者的心血管危险因素(尤其是LDL胆固醇)比血液透析患者更常见。

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