Τόμος 21 (2007) – Τεύχος 1 – Άρθρο 5 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Διεθνής Έκδοση – Volume 21 (2007) – Issue 1 – Article 5 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-International Edition

1.      Faculty of Health and Caring Professions (F.H.C.P.), Technological Educational Institution (TEI) of Athens, Athens, Greece

2.     Foundation of Biomedical Research, Academy of Athens, GR-11527 Athens, Greece

3.     Agia Olga Konstantopoulio General Hospital, N. Ionia, Athens, Greece

4.     Theageneio Hospital, Thessaloniki, Greece

5.     National School of Public Health, Athens, Greece

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Methods: We retrospectively studied 128 hemodialysed (HD) pts (80 M and 48 F), mean age 73±6.5 yrs, mean time on HD 44.4±26.4 months and BMI 25.4±3 kg/m2 . They were evaluated for: age, sex, smoking, diabetes, hypertension, dyslipidemia obesity, secondary hyperparathyroidism (SHP), hypoalbuminemia, anemia, inflammation, as evidence by elevated level of hs-CRP, hyperhomocysteinemia (HOC), time on HD, fluid overload and adequacy of HD. Forty eight pts (37%) had CHD diagnosed by coronary angiography in 22 (46%) and dypiridamol ²⁰¹thallium-stress test in 26 (54%). Results: There was a statistically significant correlation between CHD and increasing age (p<0.0001). The relative risk was significantly increased concerning: 1) male over female pts (RR: 1.95, p<0.01), 2) diabetic vs non diabetic pts (RR: 2.09, p<0.001), 3) hypertensive vs non hypertensive pts (RR:2.26,P=0.002), 4) smokers vs non smokers (RR:1.69,p<0.05), 5) Patients with SHP over pts with bio-intact PTH (i-PTH) values <250pg/ml (RR:2.16, p<0.001), 6) pts with HOC over pts with normal homo-cysteine values (RR: 2.09, p<0.05), 7) pts with increased hs-CRP levels over pts with normal hs-CRP levels (RR:1.80, p<0.01), 8) pts undergoing HD for 36 vs 12 months (RR: 1.71, p=0.03), 9) between pts with inadequate or adequate HD (RR: 1.73, p =0.02). Conclusions: Coronary heart disease in elderly (over 65 years) HD pts are strongly related with parameters to metabolic dysfunction (diabetes, SHP, HOC), smoking habits, inflammation (hs-CRP), hemodynamic condition (hypertension, HD inadequacy) but are not related to obesity and dyslipidemia. Considering the high morbidity and mortality of HD elderly pts these parameters could be useful for the secondary prevention and possible therapeutic intervention of coronary heart disease.

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