Chronic renal failure – cardiovascular risk factor.

Cardiovascular diseases are a major cause of morbidity and mortality in patients at the end stage of renal disease. Left ventricular hypertrophy, coronary heart disease and heart failure are the most prevalent cardiovascular diseases in dialysis patients. The patients on chronic dialysis have a 10 to 20-fold higher risk of development of cardiovascular disease than the general population. The aim of this article was to define the frequency of risk factors (traditional and non-traditional) for cardiovascular diseases in dialysis patients. The most frequent traditional factors in this study were hypertension (62%) and hyperlipidemia (60%), while anemia (86%) and hyperhomocysteinemia (82%) were the most frequent non-traditional factors. To present the study and repeat again that dialysis patients have high risk of development of cardiovascular disease and this population should be an ideal target group for primary prevention

Valvular heart disease in patients undergoing chronic hemodialysis.

Valvularna bolest srca uobičajena je pojava kod pacijenta na kroničnoj dijalizi. Abnormalnosti uključuju valvularno i anularno zadebljanje te kalcifikaciju bilo koje od srčanih valvula, uzrokujući regurgitaciju i/ili stenozu. Valvularno zadebljanje ili skleroza kod pacijenata na kroničnom programu dijalize najčešće zahvaća aortnu i mitralnu valvulu. Kalcifikacija aortne valvule registrira se i do polovice hemodijaliznih pacijenata, javljajući se od 10 do 20 godina ranije nego u općoj populaciji. Valvularna regurgitacija javlja se najčešće na mitralnoj, trikuspidnoj i nešto rjeđe aortnoj valvuli. Cilj rada bio je utvrditi učestalost bolesti srčanih zalistaka u asimptomatskih bolesnika na kroničnom programu dijalize. U analizu je uključeno ukupno 50 pacijenata i to 35 (70%) liječenih hemodijalizom i 15 (30%) kontinuiranom ambulatornom peritonejskom dijalizom. Valvularno zadebljanje ili skleroza dijagnosticirani su kod 20 (40%) bolesnika. Kod 9 (18%) pacijenata dijagnosticirana je skleroza mitralnih, a kod 11 (22%) skleroza aortnih listića. Kalcifikacije srčanih zalistaka dijagnosticirane su kod 12 (31%) pacijenta. Blaga aortna stenoza bila je prisutna kod 3 (6%) pacijenta. Mitralna regurgitacija bila je dijagnosticirana kod 38 (76%) pacijenata, aortna regurgitacija kod 14 (28%), a trikuspidna regurgitacija kod 24 (48%) pacijenata. Radi evaluacije stanja valvularanog aparata svim pacijentima na kroničnom programu dijalize potrebno je učiniti ehokardiografski pregled, obzirom na visoku učestalost valvularnih bolesti srca.Valvular heart disease is a common phenomenon in patients undergoing chronic hemodialysis. Abnormalities include valvular and annular thickening and calcification of any of the heart valves, causing regurgitation and/or stenosis. Valvular thickening or sclerosis in patients undergoing chronic dialysis treatment usually affects the aortic and mitral valve. Aortic valve calcification is recorded in up to a half of hemodialyzed patients, occurring from 10 to 20 years earlier than in the general population. Valvular regurgitation occurs mostly in mitral, tricuspid and less commonly in aortic valve.The aim of the article was to determine the incidence of valvular heart disease in asymptomatic patients undergoing chronic dialysis. The analysis involves a total of 50 patients, of whom 35 (70%) are treated by hemodialysis and 15 (30%) by continuous ambulatory peritoneal dialysis. Valvular thickening or sclerosis was diagnosed in 20 (40%) patients. Sclerosis of mitral cusps was diagnosed in 9 (18%) patients and sclerosis of aortic cusps was diagnosed in 11 (22%) patients. Heart valve calcifications were diagnosed in 12 (31%) patients. Mild aortic stenosis was present in 3 (6%) patients. Mitral regurgitation was diagnosed in 38 (76%) patients, aortic regurgitation in 14 (28%), and tricuspid regurgitation in 24 (48%) patients. The evaluation of the valve apparatus for all patients undergoing chronic dialysis program requires echocardiographic examination that is to be performed, considering the high prevalence of valvular heart diseases