Hemodiyaliz Amaçlı Açılan Arterio-venöz Fistüllerde Gelişen Endotel Disfonksiyonuna Statinlerin Etkisi

Yıl 2019, Cilt: 3 Sayı: 1, 27 - 32, 25.04.2019

Mustafa Etli Turhan Yavuz Mustafa Kayan Mehmet Tuğrul Sezer

https://doi.org/10.30565/medalanya.511795

Cited By: 2

Öz

Amaç: Bu çalışmamızda; düzenli ve yeterli şekilde, en az 6 aydır, son dönem böbrek hastalığı nedeniyle hemodiyalize giren hastalarda Atorvastatin tedavisinin antihiperlipidemik etkilerinin yanında endotel disfonksiyonu(ED) üzerine etkisine akım aracılı dilatasyon (flow-mediated dilation, FMD) testi ile bakarak statinin arterio venöz fistül açıklığı üzerine etkilerini araştırdık. 

Hastalar ve Yöntem: Çalışmada 15 kontrol ve 15 atorvastatin alan hasta incelendi. ED’nun değerlendirilmesi daha önce tanımlandığı şekilde FMD Ölçümü yapılarak fistül olan kolda brakial arterdeki akım aracılı dilatasyonun değerlendirmesi ile yapıldı. 

Bulgular: LDL ilk ve son değer farkının statin verilen ve verilmeyen gruplara göre bağımsız T-testi ile karşılaştırlmasında; Statin verilen gurupta LDL değerleri istatistiksel olarak belirgin anlamlıydı (p=0,000, p<0,01). Ayrıca FMD ilk ve son değer farkının statin verilen ve verilmeyen gruplara göre göre bağımsız T-testi ile karşılaştırlmasında ise: Statin verilen gurupta FMD değerleri verilmeyenlere göre istatistiksel olarak anlamlıydı (p =0,001, p< 0,01). 

Sonuç: Yaptığımız çalışmada da endotel disfonksiyonunu göstermek için uyguladığımız FMD test sonuçları; i) statin gurubuyla, kontrol gurubu karşılaştırıldığında statin gurubu lehine istatiksel olarak anlamlı olduğu, ii) statin gurubunda ateroskleroz gelişimindeki azalmaya bağlı olarak fistül gelişimi ve açıklık oranının istatiksel olarak daha anlamlı olduğu şeklinde açıklanabilir. Bu bulgular doğrultusunda statin AVF hastalarında kısa dönem fistül açıklığının sağlanması ve diyalize giriş yolunun ek işleme gerek kalmadan korunması yönünden statin kullanımının gerekli olduğu düşüncesindeyiz 

Anahtar Kelimeler

Hemodiyaliz, statinler, endotelyal disfonksiyon

The Effect of Statins on the Developing Endotal Dysfunction in Arterioveneic Fistules Opening for Hemodialysis

Öz

Aim: In this study; we investigated the effects of atorvastatin treatment on endothelial dysfunction (ED) as well as antihyperlipidemic effects of atorvastatin treatment in patients with hemodialysis due to end-stage renal disease for at least 6 months. 

Materials and Method: In this study, 15 control and 15 atorvastatin patients were examined. Evaluation of ED was performed by evaluating the flow-mediated dilatation of the brachial artery in the fistula which was performed as described previously. 

Results: Comparing the first and last value difference of LDL with independent T-test for statin given and not given groups; LDL values were statistically significant in statin group (p = 0.000, p <0.01). In addition, the comparison of the first and last value difference of FMD with the independent T-test according to statin given and not given groups: According to the statin group, the FMD values were statistically significant (p = 0.001, p <0.01). 

Conclusion: In our study, we applied FMD test results to demonstrate endothelial dysfunction; i) statin group is statistically significant in favor of statin group compared to control group, ii) fistula development and patency rate is statistically more meaningful in statin group due to decrease in atherosclerosis development. In view of these findings, we believe that statin use is necessary to ensure short-term fistula patency in statin AVF patients and to protect the dialysis access path without the need for additional processing. 

Anahtar Kelimeler

Hemodiyaliz, statinler, endothelial dysfunction

Kaynakça

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