Hemodiyaliz Hastalarında Yüksek Serum Ürik Asit/HDL-Kolesterol Oranı Kardiyovasküler Risk ile İlişkilidir

Year 2022, Volume: 32 Issue: 2, 159 - 166, 29.04.2022

Ahmet Cizmecioglu , Mevlüt Hakan Göktepe , Hilal Akay Çizmecioglu , Zeynep Bıyık , Yasemin Coşkun Yavuz , Lütfullah Altıntepe

https://doi.org/10.54005/geneltip.1041116

Abstract

Amaç: Kronik böbrek hastalığı (KBH), kardiyovasküler (KV) komorbiditelerin sık olduğu ilerleyici bir hastalıktır. Yüksek ürik asit/HDL-kolesterol oranı (UHR) sonuçlarının periton diyalizi alan hastalarda dikkate değer bulunmuştur. Bu çalışmada bu nedenle diyaliz hastalarında UHR sonuçlarını değerlendirmeyi amaçladık.
Gereç ve yöntem: Bu retrospektif, çok merkezli, kesitsel çalışma KBH hastaları ile normal glomerüler filtrasyon hızına (GFR) sahip hipertansif hastaları içeren bir kontrol grubu ile yürütüldü. Laboratuvar, ayaktan kan basıncı takibi ve demografik kayıtları iki üniversite hastanesinin dahiliye ve nefroloji bölümlerinden temin edildi. Hasta grubu daha sonra GFR'ye göre beş alt gruba ayrıldı.
Bulgular: Çalışmaya toplam 124 KBH hastası ve 127 kontrol katıldı. Tüm KBH hastaları ayrıca prediyalitik ve diyalitik olarak tanımlandı. KBH'li grupta UHR, non-dipper kan basıncı paterni ve gece kalp hızı (KH) kontrol grubuna göre artmıştı. Non-nipper KH ve gece KH, yüksek UHR’si olan diyaliz hastalarında prediyalitik olanlara göre hastalık progresyonuyla daha anlamlıydı. HbA1c’si hedefte olan diyabetik hastalardan yüksek UHR'leri olanlarda hala gece diyastolik KB yükselmeleri vardı. Son olarak, nabız dalga hızı için evreye özel bir sonuç yoktu.
Sonuç: Sonuçlarımıza göre, yüksek UHR'leri olan diyaliz hastaları, KV riskle ilişkili olarak daha yüksek non-dipper PR, gece KH ve gece diyastol kan basıncına sahiptir. Ayrıca, yüksek UHR'leri olan diyaliz hastalarında etkili bir diyabet yönetimi KV riskini önlemeyebilir.

Keywords

Ambulatuar kan basıncı takibi, Diabetes mellitus, Hemodiyaliz, Kardiyovasküler risk, Yüksek yoğunluklu lipoprotein, Serum ürik asidi.

Supporting Institution

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Project Number

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Elevated Serum Uric Acid to HDL-Cholesterol Ratio is Related to Cardiovascular Risk in Patients Receiving Hemodialysis

Abstract

Aim: Chronic kidney disease (CKD) is a progressive disease in which frequent cardiovascular (CV) comorbidities. High uric acid to HDL-cholesterol ratio (UHR) results were quite notable in patients receiving peritoneal dialysis. Thus, in this study, we aimed to evaluate the UHR results in dialysis patients.
Materials and Methods: This retrospective, multicenter, cross-sectional study was conducted with CKD patients, and the control group consisted of hypertensive patients with a normal glomerular filtration rate (GFR). Patients’ laboratory, ambulatory blood pressure monitoring, and demographic records were obtained from the follow-up cases of two university hospitals’ internal medicine and nephrology departments. The patients' group then were divided into five subsets according to GFR.
Results: A total of 124 CKD patients and 127 control participated in this study. All CKD patients were also identified as pre-dialysis and dialysis. The cases of UHR, non-dipper blood pressure pattern, and nocturnal heart rate (HR) were increased in CKD compared to the control group. Per disease progression, the non-dipper HR and nocturnal HR were more significant in patients receiving dialysis with high UHR than in the pre-dialysis subset. In diabetic patients with an on-targeted HbA1c, those with high UHRs still had nocturnal diastolic BP elevations. Finally, there was not an exact stage-specific result for pulse wave velocity.
Conclusions: Based on our results, dialysis patients with high UHRs have higher non-dipper PR, nocturnal heart rate, and nocturnal diastole blood pressure, associated with CV risk. Moreover, effective diabetic management might not prevent CV risk in dialysis patients with high UHRs.

Keywords

Ambulatory blood pressure monitoring, Cardiovascular risk, Diabetes mellitus, Hemodialysis, High-density lipoprotein, Serum uric acid.

Project Number

yok

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