Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Abstract

Introduction: Patients with chronic kidney disease (CKD) experiment a synergistic effect of the traditional and the emerging uremia-related risk factors for atheroscle- rosis. Objective: Draw the epidemiologic profile of a group of CKD patients who underwent cardiac evaluation. Methods: Symptomatic patients, patients with ische- mia on myocardial scintigraphy and/or systolic dysfunction on echocardiography, patients older than 50 years and diabetes mellitus (DM) as a cause of CKD, and tho- se with two or more risk factors underwent coronary angiography. Asymptomatic, non- diabetic patients and patients with no risk factors were investigated with echocardio- graphy. Those with a single risk factor we- re investigated with echocardiography and scintigraphy. Results: 46 patients (58.7% men) were enrolled. Their mean age was 50.7 ± 11.7 years. 91.3% were on dialy- sis, for 61.96 ± 55.1 months. Hypertension was the cause of CKD in 56.5%. Of the 28 patients (60.9%) who underwent angio- graphy, 53.6% had coronary artery disease (CAD). The patients were divided into three groups: those with CAD (A), those without CAD (B) and those who didn’t undergo co- ronary angiography (C). A significant diffe- rence occurred only between groups B and C, as regards an abnormal ABI (p = 0.026), with no ABI abnormality in group C, and as regards the mean age, which was higher in group B (p = 0.045). In group A, 53.3% of the patients were in the preoperative sta- ge of parathyroidectomy. Conclusion: This study confirmed the high rate of cardiovas- cular disorders, including CAD, in patients with CKD, especially those on dialysis. Keywords: