الفهرس 
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Abstract
Epidemiological and clinical studies have shown that damage of large arteries is a major contributory factor to the high cardiovascular morbidity and mortality of end‐stage renal disease (ESRD) patients.
The early diagnosis of vascular calcifications and the identification of their cause raise the hope for a possible direct therapeutic intervention that might reduce cardiovascular disease in haemodialysis patients.
In Our study, 100 haemodialysis patients from both sexes were evaluated and randomly selected from Dialysis Unit in Sohag University Hospital. Patients treated with haemodialysis for less than12 months and those with previous parathyroidectomy were excluded from the study.
Patients were subjected to: History taking included age, sex, HD duration, history of diabetes, hypertension, presence of previous vascular disease and estimation of calcitriol doses (μg/week) and calcium carbonate doses (g/day), measurement of body mass index, systolic and diastolic blood pressure.
Serum levels of Ca, P and PTH level were evaluated. Arterial stiffness was measured by PP. SVCS was evaluated in plain X-ray of pelvis and hands.
In our study, we found a high prevalence of vascular calcifications in haemodialysis patient which constituted near half of the patients in the study as patients diagnosed to have vascular calcifications were 50 patients (50%). A SVCS ≥ 3 and a PP > 70 mmHg were observed in 36 and 24 patients, respectively.
Also, we found that the presence of vascular disease was associated with higher pulse pressure (P=0.007), history of hypertension (P=0.001), and elevated systolic blood pressure (P=0.002), and higher serum PTH (P = 0.03).
Age, sex, diabetes, haemodialysis duration, calcium carbonate and calcitriol doses, diastolic BP values, dry weight, BMI, calcium, phosphate levels and SVCS were not correlated with higher pulse pressure in these patients.
Also, in our study we found that higher simple vascular calcification score ≥3 was associated with older age (P=0.003), history of hypertension (P=0.002), and elevated systolic blood pressure (P = 0.002), and the presence of prevalence of vascular disease (P = 0.01).
Age, sex, diabetes, haemodialysis duration, calcium carbonate and calcitriol doses, history of vascular disease, diastolic BP values, dry weight, BMI, calcium, phosphate, PTH levels and pulse pressure were not correlated with higher SVCS in these patients.
In our study, simple and inexpensive methods such as the evaluation of PP or the assessment of the SVCS with plain X-ray were enough to detect higher cardiovascular risk. Diagnosis of arterial stiffness and vascular calcification has the advantage of also providing important information that can be used for guiding therapeutic intervention in dialysis patients.
Recommendations
We recommend Dialysis Unit in Egypt especially in Upper Egypt to use pulse pressure and the plain X-ray for assessment of the SVCS in the diagnosis of vascular calcifications as a routine investigations, because they are simple and inexpensive methods enough to detect higher cardiovascular risk. We recommend a similar study to evaluate the arterial stiffening and vascular calcifications in end‐stage renal disease (ESRD) patients in Egypt especially in Upper Egypt.