Fosinopril carries less risk of hyperkalemia in hypertensive hemodialysis patients than enalapril. Although definite conclusion may be drawn after well-designed studies, the results presented in this pilot study suggest that fosinopril may be recommended for hypertensive hemodialysis patients who are at risk to develop inter-dialytic hyperkalemia.

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Postdilution on-line hemodiafiltration in comparison with standard hemodialysis provided the more effective elimination of small and middle uremic toxins molecules and a significantly higher degree of biocompatibility. The patients treated with standard hemodialysis frequently do not achieve the minimal value of urea Kt/V index prescribed by National Kidney Foundation-Dialysis Outcomes Quality Inatiatives standards. These patients also have significantly higher serum CRP values which suggest the state of chronic microinflammation.

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(1) SLUŢBA ZA NEFROLOGIJU I HEMODIJALIZU, OPŠTA BOLNICA ZAJEĈAR, (2) PRIVATNA INTERNISTIĈKA ORDINACIJA "DR BASTAĆ", (3) SLUŢBA ZA LABORATORIJSKU DIJAGNOSTIKU, OPŠTA BOLNICA ZAJEĈAR Sažetak:Kalcifikacija srĉanih valvula je ĉest nalaz kod bolesnika u terminalnom stadijumu hroniĉne bubreţne bolesti (HBB) i udruţena je sa povećanim ukupnim i kardiovaskularnim mortalitetom. Cilj ovog istraţivanja je da se utvrdi uĉestalost i faktori rizika povezani sa kalcifikacijom srĉanih valvula kod bolesnika u IV i V stadijumu HBB koji još nisu zapoĉeli leĉenje dijalizom. Istraţivanjem je obuhvaćen 61 bubreţni bolesnik (34 M, proseĉne starosti 62,6±13,6 godina) i 22 zdrave osobe srodne po starosti i polu. Svaki ispitanik je podvrgnut kliniĉkoj proceni, laboratorijskom ispitivanju, ehokardiografskom pregledu i ultrazvuĉnom pregledu karotidnih arterija. Kalcifikacije u predelu aortne i mitralne valvule su registrovane znaĉajno ĉešće u grupi bolesnika sa HBB nego u kontrolnoj grupi (47,5% : 9,1%; p=0,001). Bubreţni bolesnici su podeljeni prema prisustvu valvularnih kalcifikacija u 2 grupe: grupu A, sa kalcifikacijama (n=29) i grupu B, bez kalcifikacija (n=32). Bolesnici iz grupe A bili su znaĉajno stariji (p<0,01), imali su niţi klirens kreatinina (p<0,01) i više nivoe P (p<0,05), proizvoda CaxP (p<0,05) i PTH (p<0,05) nego bolesnici iz grupe B. Ehokardiografskim pregledom u grupi A je utvrĊeno ĉešće prisustvo hipertrofije leve komore (LVH, p <0,01) u odnosu na grupu B. Pregledom karotidnih arterija u grupi A je izmerena veća debljina intime-medije (IMT, p<0,001) i zabeleţeno je ĉešće prisustvo kalcifikovanih plakova (p=0,005) u poreĊenju sa grupom B. Valvularne kalcifikacije su visoko zastupljene već u predijaliznom periodu HBB i udruţene su sa poremećajima mineralnog metabolizma, hipertrofijom leve komore i vaskularnim kalcifikacijama. Ključne reči:valvularna kalcifikacija, hroniĉna bubreţna bolest, faktori rizika Summary:Valvular calcification is a common finding in patients with end-stage chronic kidney disease (CKD) and associated with increased all-cause and cardiovascular mortality. The aim of the study was to determine the prevalence and risk factors associated with cardiac valve calcification in patients with stage IV and V CKD, not yet on dialysis. The study enrolled 61 CKD patients (34 M, mean age 62.6±13.6 years) and 22 ageand sex-matched healthy controls. All participants underwent a clinical assessment, laboratory analyses, echocardiography and carotid artery ultrasound. Calcification of the aortic and mitral valve was more frequently in patients with CKD stages IV-V than the healthy controls (47.5% : 9.1%, p=0.001). CKD patients were divided according to the presence of valvular calcification in 2 groups: group A with calcification (n=29) and group B without calcification (n=32). Patients from group A were significantly older (p<0.01), had lower creatinine clearance (p<0.01), and higher levels of P (p <0.05), CaxP product (p<0.05) and PTH (p<0.05) compared to patients from group B. Echocardiography showed a higher pre...