| Theme |
Blood Access for Chronic Hemodialysis Therapy -- The Present Problems and New Developments |
| Title |
Vascular properties in patients receiving maintenance hemodialysis |
| Author |
Takahiko Kawagishi |
Second Department of Internal Medicine, Osaka City University Medical School |
| Author |
Yoshiki Nishizawa |
Second Department of Internal Medicine, Osaka City University Medical School |
| [ Summary ] |
The association between uremia and an increased risk of cardiovascular disease has been documented in many population groups. Ather osclerotic lesions are moderately or severely advanced by the time they produce clinical signs or symptoms. The measurement of the intima-media thickness of the carotid and femoral arteries revealed that atherosclerosis was accelerated in uremic patients on maintenance hemodialysis. Both aortic pulse-wave velocity and stiffness beta of the carotid artery show higher values in uremic patients on maintenance hemodialysis than in age-matched controls. Many dialysis patients with cardiovascular disease have identifiable heart disease prior to entering maintenance dialysis therapy. The incidence of ischemic heart disease during dialysis was not different from nondialyzed subjects. In addition, there was no difference in intima-media thickness or stiffness beta of the carotid artery between uremic patients on maintenance hemodialysis, and prior to the initiation of dialysis therapy. Atherosclerosis in uremic patients may be accelerated prior to the initiation of dialysis therapy. However, longitudinal studies are required to determine whether the uremic state accelerates atherosclerosis or not. |