ARTERIOSCLEROSIS IN DIALYSIS PATIENTS

Arteriosclerosis is a constant problem;in long-term hemodialysis patie nts. Computer tomography of the abdominal aorta allows a well-defined and reproducible evaluation of aortosclerosis. In the cross-sectional study, aortosclerosis was significantly accelerated in 84 chronic hemo dialysis patients and was comparable to the results found in 20-year o lder control patients without renal disease. The increase of aortoscle rosis correlated significantly with age of the patient, smoking, and d uration of dialysis therapy. Furthermore, increased VLDL cholesterol a nd decreased HDL cholesterol seem to enhance aortosclerosis in our dia lysis patients. In the longitudinal study (two CT scans with a time in terval of 87 +/- 62.7 months) in 36 dialysis patients, progressed aort osclerosis correlated significantly with the long duration of hypertri glyceridemia, VLDL cholesterol, uric acid, and calcium phosphate produ cts. Progression of aortosclerosis was reduced in parathyroidectomized patients. The study suggests that premature aortosclerosis is found i n dialysis patients. In addition to the common risk factor of aortoscl erosis, disturbed calcium phosphate and parathyroid hormone metabolism seem to enhance aortosclerosis in patients under maintenance hemodial ysis.