ISCHEMIC HEART-DISEASE IN PATIENTS WITH UREMIA UNDERGOING MAINTENANCE HEMODIALYSIS

被引:207
作者
ROSTAND, SG
GRETES, JC
KIRK, KA
RUTSKY, EA
ANDREOLI, TE
机构
[1] UNIV ALABAMA,MED CTR,DEPT BIOSTAT,BIRMINGHAM,AL 35294
[2] VET ADM HOSP,NEPHROL SECT,BIRMINGHAM,AL 35233
基金
美国国家卫生研究院;
关键词
D O I
10.1038/ki.1979.170
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The 6 year cumulative incidence of ischemic heart disease (IHD) in 382 dialysis patients (mean age [SEM], 43 ± 0.7 years) was studied. Of 101 patients with IHD, only 39 developed symptoms following dialysis (cumulative incidence, 20.8%). This group was older than those with IHD, and in 55%, IHD occurred in the first year of dialysis. Analysis by sex and race showed the rate of IHD in men and women to be similar, but the rate in whites was twice that in blacks. In men, the rate was not different from nondialysis men with similar coronary risk factors, whereas in dialysis women, the rate was twice that of a nondialysis cohort. The development of IHD did not adversely affect long-term survival in patients without prior evidence of IHD. Death from myocardial infarction occurred in 3 of 320 patients at risk. Autopsy data in 33 patients revealed 70% stenosis of coronary arteries in 7, 4 of whom had antecedent disease. Our major conclusions are: the incidence of IHD during dialysis was not different from similarly matched nondialysis subjects; the rate of IHD in dialysis women was greater than it was in nondialysis subjects; coronary artery disease only affected long term survival of patients with preexisting disease; autopsy data did not suggest accelerated atherosclerosis.
引用
收藏
页码:600 / 611
页数:12
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