Abstract
Aim. To evaluate the frequency and effects on prognosis of conventional and optional cardiovascular risk (CVR) factors in hemodialysis patients.Material and methods. The study included 82 patients receiving hemodialysis. Clinical examination was carried out. We also assesed heart rate variability and pulse wave velocity by photoplethysmography. To identify significant prognostic factors and determine the range of their values, the decision tree method was used.Results. In hemodialysis patients, the prevalence of hypertension and overweight was higher than in the general population — 100% vs 33,8% and 51,2% vs 29,7%, respectively; the smoking prevalence was comparable — 25,6% vs 25,7%; the prevalence of hypercholesterolemia was lower than in the general population — 45,1% vs 57,6%. Optional CVR factors in hemodialysis patients were as follows: level of pulse pressure, duration of hypertension, hemoglobin level, pulse wave velocity, standard deviation normal to normal (SDNN), left ventricular ejection fraction. Based on a combination of significant CVR factors, 5 rules for predicting a favorable or unfavorable outcome in hemodialysis patients were identified.Conclusion. The use of proposed rules allows to develop novel measures and improve current ones aimed at modifying CVR factors and increasing the survival of hemodialysis patients.
Highlights
The use of proposed rules allows to develop novel measures and improve current ones aimed at modifying cardiovascular risk (CVR) factors and increasing the survival of hemodialysis patients
Factors affecting the stiffness of the arteries in patients with end-stage chronic renal failure who are on different types of replacement therapy
Summary
The use of proposed rules allows to develop novel measures and improve current ones aimed at modifying CVR factors and increasing the survival of hemodialysis patients. А. — к.м.н., доцент кафедры пропедевтики внутренних болезней, ORCID: 0000-0003-2583-5648, Овсянников Н. Кафедрой пропедевтики внутренних болезней, ORCID: 0000-0002-9945-7881, Усачева Е. В.* — к.м.н., доцент кафедры пропедевтики внутренних болезней, ORCID: 0000-0002-6134-1533, Куликова О. Основной причиной смерти пациентов с ТХПН являются сердечно-сосудистые события (ССС), которые составляют 40-50% причин всех случаев смерти [3,4,5,6]. Стратификация пациентов с ТХПН в соответ ствии с риском ССС является сложной задачей, поскольку традиционные алгоритмы прогнозирования сердечно-сосудистого риска (ССР), такие как SCORE (Systematic Coronary Risk Evaluation) и Framin gham, недооценивают риск развития ССС у пациентов с ТХПН [7, 8]. Цель исследования — оценить частоту традиционных факторов ССР, выделить факультативные факторы ССР и оценить их влияние на прогноз благоприятного или неблагоприятного исхода у пациентов с ТХПН, находящихся на программном ГД
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