| Theme |
Risk Factors and Outcome on Long-term Dialysis |
| Title |
Cerebral and peripheral vascular disease in hemodialysis patients |
| Author |
Hidemi Nishida |
Third Department of Internal Medicine, Kurume University School of Medicine |
| Author |
Takayuki Fujino |
Department of Surgery, Kurume University School of Medicine |
| Author |
Seiya Okuda |
Third Department of Internal Medicine, Kurume University School of Medicine |
| [ Summary ] |
Atherosclerotic vascular lesions have been reported to be more frequent in hemodialysis patients as compared to the age-matched general population. Therefore, it is important for dialysis patients to prevent and treat cerebral or peripheral vascular diseases, associated with the development of atherosclerosis in dialysis patients. Cerebral bleeding is most common in cerebral vascular disease in HD patients. Hypertension may also play an important role for this accident. Subarachinoidal hemorrhage and subdural hemorrhage also more frequently occur in HD patients, compared to normal subjects. The prognosis for these patients is poor, probably due to the usage of anti-coagulant agents. Acute drops in blood pressure during or after HD sessions should be avoided in HD patients who have stenotic vascular lesions, because the drop may aggravate cerebral ischemia. Metabolic disorders of calcium may contribute to the calcification of vascular walls, which results in severe stenosis of the peripheral arteries in long-term HD patients. The prevention of infection and the correct choice of surgical therapy are important for the management of peripheral vascular disease in diabetic HD patients. |