KALCIFIKACIJE KORONARNIH ARTERIJ IN ATEROSKLEROZA PRI BOLNIKIH ZDRAVLJENIH S KRONIčNO HEMODIALIZO (Slovene)

The fact that the mortality and morbidity of the diabetic patients and patients with terminal renal failure are larger than in control groups of coresponding gender,and age is cousing concern. The aim of our study was to evaluate the influence of two diseases and factors conected with them on progression of coronary calcification (CC). We found that CC are higher in haemodialysis patients. Positive correlations existed between CC and intima media thickness (IMT) , age and BMI. In patients with type 2 diabetes without renal disease baseline CC had negative correlation with albumine, but final CC correlated with fetuin A and insulin dose. According to thees results our therapy have to be oriented to thees factors.

Determination of coronary calcification by spiral CT was performed in Slovenia for the first time. Included hemodialysis patients were without diabetes and patients with type 2 diabetes were without kidney disease. It has been shown that hemodialysis patients more pronounced coronary calcification than patients with diabetes mellitus type 2. It is also shown that coronary artery calcification in hemodialysis patients progress less if patients receive paricalcitol. This is a very important finding. Paricalcitol is in Slovenia only partially paid by the insurance company. This study argues for greater use of paricalcitol in patients with chronic kidney disease.