Document Detail

Onset of coronary artery disease prior to initiation of haemodialysis in patients with end-stage renal disease.
MedLine Citation:
PMID:  9141000     Owner:  NLM     Status:  MEDLINE    
To determine whether the onset of coronary artery disease may precede the initiation of dialysis in patients with end-stage renal disease, we performed coronary angiography within 1 month of initiation of maintenance haemodialysis in 24 patients (age range 42-78 years; mean 63.7 +/- 11). Coronary angiography was performed regardless of the absence or presence of angina. Fifteen patients had diabetic nephropathy, and nine had non-diabetic nephropathy. Significant coronary stenosis was defined as at least 75% narrowing of the reference segment. Fifteen patients (62.5%) with a total of 49 lesions were classified as the coronary artery disease present group. Eleven of those 15 (73.3%) had multivessel disease. The average number of stenotic lesions was 3.3 per patient. The most common patterns of stenosis were complex (23 lesions; 47%), and diffuse lesions over 20 mm long (14 lesions; 29%). None of the clinical or haematological factors evaluated differed significantly between the groups with and without coronary artery disease. The prevalence of coronary artery disease was 72.7% in the symptomatic patients and 53.8% in the asymptomatic patients. The diagnosis of coronary artery disease at the start of maintenance haemodialysis based only on chest symptoms and clinical factors proved to be difficult. Coronary angiography is thus essential for evaluating coronary artery disease in uraemic patients. Many patients with end-stage renal disease had coronary artery disease prior to the start of haemodialysis.
N Joki; H Hase; R Nakamura; T Yamaguchi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  12     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-07-18     Completed Date:  1997-07-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  718-23     Citation Subset:  IM    
Third Department of Internal Medicine, Toho University Ohashi Hospital, Tokyo, Japan.
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MeSH Terms
Chest Pain
Coronary Angiography
Coronary Disease / diagnosis,  etiology*,  radiography
Diagnostic Errors
Kidney Failure, Chronic / complications*,  therapy*
Middle Aged
Renal Dialysis / adverse effects*
Risk Factors

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