Intraoperative Arterial Biopsy in Incident Hemodialysis Patients: Differences Observed
| Autor: | Dina O Abdulazim, Wael Mostafa Hamza, Usama A Sharaf El Din, Mona M Salem, Ahmed Fayed, Hossam El Mahdy, Ahmed M. Soliman |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Tunica media medicine.medical_specialty Biopsy medicine.medical_treatment 030232 urology & nephrology Urology 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Renal Dialysis medicine Humans Renal replacement therapy Renal Insufficiency Chronic Vascular Calcification medicine.diagnostic_test business.industry Phosphorus Middle Aged Tunica intima medicine.disease Fibroblast Growth Factors Fibroblast Growth Factor-23 Arterial calcification medicine.anatomical_structure Parathyroid Hormone Female Hemodialysis Tunica Intima Tunica Media business Kidney disease Calcification |
| Zdroj: | Nephron. 143:54-61 |
| ISSN: | 2235-3186 1660-8151 |
| Popis: | Introduction: Arterial calcification (AC) is a common complication in chronic kidney disease (CKD) patients that starts to develop before these patients need renal replacement therapy. In these patients, calcification can involve tunica intima or tunica media. This study has looked for the prevalence, severity, and distribution of arterial wall calcification in incident hemodialysis patients through intraoperative arterial biopsy obtained during creation of arteriovenous vascular access for hemodialysis. Methodology: One hundred and seventy-two stage 5 CKD adults (98 male and 74 female) were included. Beside histopathology of the obtained arterial samples, all these cases were tested for serum calcium (Ca), phosphorus (P), alkaline phosphatase, uric acid, parathormone (PTH), fibroblast growth factor 23 (FGF23), and 25 hydroxy vitamin D. Results: Eighty six (50%) of the cases had AC (group I); 29 (17%) as intimal (subgroup Ii), 36 (21%) as medial (subgroup Im), while 21 (12%) had both intimal and medial calcification (subgroup Iim). Eighty-six patients (50%) were devoid of calcification (group II). Apart from the significantly higher serum level of PTH in group I, statistical analysis failed to disclose significant difference in any of the other studied parameters between the 2 groups. On the other hand, there were significant differences in serum P, Ca × P product, serum PTH, and FGF23 between patients according to intensity of calcification. Conclusion: Half of incident hemodialysis CKD patients have developed AC mainly in tunica media. Discrepancy in serum P can have an impact on calcification intensity. |
| Databáze: | OpenAIRE |
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