Altay Kandemir, Gökhan Nergizoğlu

Hemodiyaliz Hastalarında Abdominal Aort Anevrizması Sıklığı ve Risk Faktörleri

Amaç: Asemptomatik ve rüptüre abdominal aort anevrizması (AAA) sıklığı ve yaş-standartize mortalitesi giderek artmaktadır. Biz bu çalışmada hemodiyaliz tedavisi alan hastalarda geleneksel risk faktörleri ve kronik böbrek yetmezliği ile ilişkili risk faktörlerinin AAA etiopatogenezinde de temel faktörler olması nedeniyle ultrasonografi (USG) ile AAA sıklığını saptamayı amaçladık.Gereç-Yöntemler: Toplam 8 diyaliz merkezinden 647 (341 erkek/306 kadın, 58.3±11.6 yıl ) hasta ve 185 (102 erkek/83 kadın, 57.4±9.6 yıl) kontrol çalışmaya alındı. B-Mode gri skala Ultrasonografik projeksiyon ile infrarenal aorta ve suprarenal aortanın transvers çap ve anterior-posterior çap ölçümleri yapıldı. Ayrıca hastaların demografik ve biyokimyasal parametreleri ile abdominal aort anevrizması arasındaki ilişki değerlendirildi. Bulgular: Hemodiyaliz hastalarında abdominal aorta anevrizması sıklığı %8.2 iken kontrol grubunda %3.8 idi (p<0.05). Cinsiyete göre değerelendirildiğinde erkeklerde anevrizma riski daha yüksek saptandı (p<0.05). Univariate analizde hemodiyaliz hastaları ve çalışma parametreleri incelendiğinde yaş, cinsiyet, hiperlipidemi ve parathormon düzeyi arasında anlamlı ilişki saptandı. Ancak multivariate analizde bağımsız değişkenler yalnızca yaş, erkek cinsiyet ve diyabetes mellitus saptandı. Sonuç: Çalışmamızda hemodiyaliz hastalarında abdominal aort anevrizması riskinin arttığı ve risk artışında en temel faktörler olarak ileri yaş, erkek cinsiyet ve diyabet mellitus varlığının ön planda çıktığını saptadık. Bulgularımız, bu risk faktörlerine sahip hemodiyaliz hastalarında düzenli tarama programları ile abdominal aort anevrizması olgularının saptanarak gerekli girişimlerin yapılmasının yaşam sürelerine katkıda bulunabileceğini düşündürmektedir.

Anahtar Kelimeler:

Abdominal aort anevrizması, Ultrasonografi, Kronik böbrek yetmezliği

ABDOMINAL AORTIC ANEURYSM OCCURENCE AND RISK FACTORS IN HEMODIALYSIS PATIENTS

Objective: Frequency and age-standardized mortality rate are increasing for asymptomatic and ruptured abdominal aortic aneurysm (AAA). Because traditional risk factors and chronic renal failure related risk factors in hemodialysis patients are recognized as the main factors in AAA etiopathogenesis, in this study we aimed to determine the frequency of AAA by ultrasonography (USG).Materials and Methods: A total of 647 patients (341 men/306 women, 58.3±11.6 years of age) from 8 dialysis centers and 185 control subjects (102 men/83 women, 57.4±9.6 years of age) were included in the study. Transverse diameter and anterior-posterior diameter measurements of infrarenal aorta and suprarenal aorta were performed with B-Mode gray scale ultrasound projection. The relationship between demographic and biochemical parameters of patients and abdominal aortic aneurysm was also evaluated.Results: The frequency of AAA was 8.2% in hemodialysis patients while 3.8% in control group (p<0.05). Men displayed a higher risk of AAA than women (p<0.05). Univariate analysis of hemodialysis patients and study parameters revealed a significant relation between age, gender, hyperlipidemia and parathormone levels. However, independent variables were determined as only age, male gender and diabetes mellitus in multivariate analysis. Conclusion: In our study, the risk of AAA was found to increase in hemodialysis patients and advanced age, male gender, and diabetes mellitus were determined as the prominent factors . Our findings suggest that the patients having these risk factors may have an improved life span with early detection and timely treatment of abdominal aortic aneurysm cases by regular screening programs in hemodialysis.

Keywords:

Abdominal Aortic Aneurysm, Ultrasonography, Chronic renal failure,

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