J.ESTEFAN, G.TORRES, R.DE TORO, S.PASCUAL, O.GARCIA, P.ABAIGAR
HOSPITAL GENERAL YAGUE. BURGOS
The objetive of this study was to examine if hyperhomocysteinemia ( HOMO ), Von Willebrand factor ( vWF ),and Ankle-Arm blood pressure index ( AABI ) are associated with occlusive vascular disease (OVD ) in hemodialysis patients.
The study design included risk factor analysis and determination of serum homocysteine, vWF, AABI, and Lipoprotein (a). Fifty five chronic uremic patients on regular hemodialysis treatment were studied.
RESULTS Eighteen patients had coronary,cerebral or peripheral signs of occlusive vascular disease.The Cerebral vascular disease was diagnosed if in the doppler sonography of the carotid arterie appeared a focal placa atheroma. The Coronary vascular disease was diagnosed by documented history of myocardial infarction. And the diagnosis of peripheral disease was establised by history of intermitent c laudication determined by patient interview, amputation of a limb resulting from obstructive arterial disease.
The homocysteine , Von Willebrand factor , Ankle-Arm blood pressue index and lipoprotein (a) in patients with OVD and without OVD, as follows:
|OCCLUSIVE VASCULAR DISEASE (N=18)||WITHOUT OCCLUSIVE VASCULAR DISEASE (N=37)|
|vWF||209 ± 74,1 %||187 ± 53,4 %I|
|Homocysteine||17,3 ± 4,5 microm/l||14,9 ± 5,9 microm/L||P< 0,09|
|AABI||1,04 ± 0,1||1,14 ± 0,1||P< 0,05|
|Lp (a)||24,5 ± 2 mg%||24,3 ± 1 mg%|
In multiple regression analysis the age was significantly associated with occlusive arterial disease (R=0,237 P<0,05).
Furthemore,serum homocysteine is close to signification (R=0,237 P=0,06). Our results support the hypothesis that AABI serves as the most powerful marker for the presence of systemic occlusive vascular disease in hemodialysis patients.