Incidence and risk factors of coronary heart disease in elderly patients on chronic hemodialysis

Abstract

Coronary heart disease incidence in elderly HD patients increases with age, male sex, diabetes, SHP, hypertension, increased CRP levels, HOC, smoking, time on HD and inadequacy of HD.

Magnesium supplementation helps to improve carotid intima media thickness in patients on hemodialysis

“…Although non-atherosclerotic factors such as volume overload and left ventricular hypertrophy are important contributors to the high cardiovascular mortality, accelerated atherosclerosis is one of the primary causes of morbidity and mortality in dialysis patients [4]. Among dialysis patients, the atherosclerotic process progresses more dynamically than in the general population because of a high prevalence of traditional risk factors and exposure to additional, nontraditional risk factors [5].…”

Vitamina D e hipertensión arterial

“…El dé ficit de vitamina D produce un aumento secundario de PTH y é sta tiene mú ltiples efectos sobre el sistema cardiovascular. Los mecanismos por los que la PTH puede producir HTA no son bien conocidos, pero se ha visto en algunos estudios que puede aumentar la rigidez de la pared arterial y promover cambios ateroescleró ticos en los vasos, sobre todo en pacientes con enfermedad renal 41,42 . A su vez, las cé lulas de la pared vascular (cé lula endotelial, cé lula de mú sculo liso y macró fagos) expresan VDR y 1-a hidroxilasa.…”

Vascular access in elderly patients with end-stage renal disease

“…In addition, older hemodialysis (HD) patients have specific age-related problems, such as carotid atherosclerosis/carotid artery stiffness [11], congestive heart failure [12], and coronary heart disease [13]. In comparison to younger individuals, elderly patients are more likely to have poor quality (or absent) forearm or leg veins because of prior medical interventions and are more likely to have atheroma or medial calcifications affecting their radial or brachial arteries [14].…”