By H. Hampl, A. Besarab
Uremia, that is linked to the deterioration of renal functionality, is a fancy procedure that affects all cardiac constructions. an important manifestations of this disease are hypertensive and anemic middle sickness, coronary artery sickness and center valve ailments. Cardiovascular ailments are hence the first reason for dying in sufferers on hemodialysis. This e-book offers recommendations to seriously lessen cardiac morbidity/mortality in uremic sufferers. the themes contain the position of oxidative tension (caused by way of anemia) in cardiovascular harm and the correction of anemia by way of erythropoietin. This correction additionally considerably reduces elevated oxidized lipoprotein species, key elements of arteriosclerosis. one other hazard issue that is mentioned is critical left-ventricular hypertrophy (LVH), which predisposes ventricular arrhythmia prompted through seriously decreased coronary reserve, usually resulting in unexpected dying
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14 Siems W, Carluccio F, Grune T, Jakstadt M, Quast S, Hampl H, Sommerburg O: Elevated serum concentration of cardiotoxic lipid peroxidation products in chronic renal failure in relation to severity of renal anemia. Clin Nephrol 2002;58(suppl 1):S20–S25. Kidney Blood Press Res 2005;28:302–306 15 Siems W, Quast S, Carluccio F, Wiswedel I, Hirsch D, Augustin W, Hampl H, Riehle M, Sommerburg O: Oxidative stress in chronic renal failure as a cardiovascular risk factor. Clin Nephrol 2002;58(suppl 1):S12–S19.
1 g/dl. The data are the mean 8 SD. The Scorrano/Lecce study (a) includes values from 56 patients (start and 2 years) and 80 controls, and the Nis study (b) values from 20 patients (start and 1 year) and 10 control persons. 8 0 a MDA (µM) Fig. 5. 25 Start Table 1. 7 Predialytic values as mean 8 SE. Table 1 shows the basic clinical chemical reference parameters related to red blood cells and anemia in the four groups of patients. Figure 5 demonstrates that with the reduction of HNE (ﬁg. 5a, data from the Scorrano/Lecce study) and MDA (ﬁg.
In heart perfusion experiments, a strong correlation was found between HNE efﬂux and functional heart damage . There is an association of enhanced serum HNE and left-ventricular dysfunction [42, 43]. The ischemic myocardial damage correlates also with HNE formation [44, 45]. Summarizing these data, one can conﬁrm that the accumulation of HNE, MDA and protein carbonyls in the blood plasma is a cardiovascular risk factor. Because of the facts known about atherogenesis and the cardiotoxicity-promoting effects of aldehydic LPO products, correction of renal anemia may offer beneﬁts for the reduction of cardiovascular risk of patients with chronic renal failure thus improving their quality of life and the prognosis of renal failure.