RISK FACTORS OF CARDIOVASCULAR AND CEREBROVASCULAR EVENTS IN PATIENTS WITH UREMIA COMPLICATED WITH HYPERTENSION DURING MAINTENANCE HEMODIALYSIS TREATMENT
Main Article Content
Keywords
Uremia, Hypertension, Cardiovascular events, Cerebrovascular events, Maintenance hemodialysis, Risk factors, Retrospective analysis, Multivariate regression, Blood pressure control
Abstract
Background: Cardiovascular and cerebrovascular events pose significant threats to patients with uremia complicated by hypertension undergoing maintenance hemodialysis treatment. Understanding the risk factors associated with these events is crucial for effective management and prevention.
Aim: The primary objective of this study was to investigate the risk factors contributing to cardiovascular and cerebrovascular events in patients with uremia complicated by hypertension undergoing maintenance hemodialysis treatment.
Methods: A retrospective analysis was conducted on a cohort of patients with uremia and hypertension who underwent maintenance hemodialysis treatment between January 2023 to August 2023 in the Nephrology Division at Khyber Teaching Hospital, Peshawar. Relevant clinical data, including demographic information, comorbidities, dialysis parameters, and medication history, were collected and analyzed. Statistical methods, including multivariate regression analysis, were employed to identify significant risk factors.
Results: The study identified several key risk factors associated with cardiovascular and cerebrovascular events in this patient population. These factors included but were not limited to age, duration of uremia, blood pressure control, lipid profile, and specific comorbidities. Notably, [mention any particularly significant findings or trends discovered during the analysis].
Conclusion: The findings underscore the importance of a comprehensive approach to managing cardiovascular and cerebrovascular risk in patients with uremia complicated by hypertension during maintenance hemodialysis treatment. Strategies targeting identified risk factors, such as optimized blood pressure control and tailored medication regimens, may play a crucial role in reducing the incidence of these events.
References
2. Miglinas M, Cesniene U, Janusaite MM, Vinikovas A. Cerebrovascular disease and cognition in chronic kidney disease patients. Frontiers in cardiovascular medicine. 2020 Jun 3;7:96.
3. Zoccali C, Mallamaci F, Adamczak M, de Oliveira RB, Massy ZA, Sarafidis P, Agarwal R, Mark PB, Kotanko P, Ferro CJ, Wanner C. Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association. Cardiovascular Research. 2023 Aug;119(11):2017-32.
4. Shah B, Jagtap P, Sarmah D, Datta A, Raut S, Sarkar A, Bohra M, Singh U, Baidya F, Kalia K, Borah A. Cerebro‐renal interaction and stroke. European Journal of Neuroscience. 2021 Feb;53(4):1279-99.
5. Rysz J, Franczyk B, Ławiński J, Gluba-Brzózka A. Oxidative stress in ESRD patients on dialysis and the risk of cardiovascular diseases. Antioxidants. 2020 Nov 3;9(11):1079.
6. Tian Y, Zhu Q, Tang Y, Li R, Xiao J. Research Progress Based on Serious Complication of Stroke in Patients with Chronic Kidney Disease. Current Research in Medical Sciences. 2023 Mar 31;2(2):40-5.
7. Kourtidou C, Tziomalos K. Epidemiology and Risk Factors for Stroke in Chronic Kidney Disease: A Narrative Review. Biomedicines. 2023 Aug 27;11(9):2398.
8. Deferrari G, Cipriani A, La Porta E. Renal dysfunction in cardiovascular diseases and its consequences. Journal of nephrology. 2021 Feb;34(1):137-53.
9. Burnier M, Damianaki A. Hypertension as cardiovascular risk factor in chronic kidney disease. Circulation research. 2023 Apr 14;132(8):1050-63.
10. Hanna RM, Ferrey A, Rhee CM, Kalantar-Zadeh K. Renal-cerebral pathophysiology: the interplay between chronic kidney disease and cerebrovascular disease. Journal of Stroke and Cerebrovascular Diseases. 2021 Sep 1;30(9):105461.
11. Wu Y, Huang B, Zhang W, Farhan KA, Ge S, Wang M, Zhang Q, Zhang M. The interaction analysis between advanced age and longer dialysis vintage on the survival of patients receiving maintenance hemodialysis. Journal of International Medical Research. 2022 Apr;50(4):03000605221088557.
12. Swastika KD, Tarigan RR. Hypertension on Dialysis Patients: Influence Factor and Management. Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI). 2022;4(4):176-90.
13. Kim IS, Kim S, Yoo TH, Kim JK. Diagnosis and treatment of hypertension in dialysis patients: a systematic review. Clinical Hypertension. 2023 Sep 1;29(1):24.
14. Liabeuf S, Pepin M, Franssen CF, Viggiano D, Carriazo S, Gansevoort RT, Gesualdo L, Hafez G, Malyszko J, Mayer C, Nitsch D. Chronic kidney disease and neurological disorders: are uraemic toxins the missing piece of the puzzle?. Nephrology Dialysis Transplantation. 2022 Jan;37(Supplement_2):ii33-44.
15. Bahrainwala JZ, Gelfand SL, Shah A, Abramovitz B, Hoffman B, Leonberg-Yoo AK. Preoperative risk assessment and management in adults receiving maintenance dialysis and those with earlier stages of CKD. American Journal of Kidney Diseases. 2020 Feb 1;75(2):245-55.
16. Marini S, Georgakis MK, Anderson CD. Interactions between kidney function and cerebrovascular disease: vessel pathology that fires together wires together. Frontiers in neurology. 2021 Nov 24;12:785273.
17. Bansal N, Artinian NT, Bakris G, Chang T, Cohen J, Flythe J, Lea J, Vongpatanasin W, Chertow GM, American Heart Association Council on the Kidney in Cardiovascular Disease; Council on Cardiovascular and Stroke Nursing; and Council on Epidemiology and Prevention. Hypertension in patients treated with in-center maintenance hemodialysis: current evidence and future opportunities: a scientific statement from the American Heart Association. Hypertension. 2023 Jun;80(6):e112-22.
18. Ameh OI, Ekrikpo UE, Bello AK, Okpechi IG. Complications of Haemodialysis. InManagement of Kidney Diseases 2023 Mar 31 (pp. 363-382). Cham: Springer International Publishing.
19. Ali S, Ajmal MS, Navaneethan SD. Management of cardiovascular risk factors and other comorbidities in chronic kidney disease. Current opinion in nephrology and hypertension. 2020 Sep 1;29(5):453-6.
20. Tan Y, Gu Y, Zhao Y, Lu Y, Liu X, Zhao Y. Effects of hemodialysis on prognosis in individuals with comorbid ERSD and ICH: a retrospective single-center study. Journal of Stroke and Cerebrovascular Diseases. 2021 May 1;30(5):105686.
21. Kim HW, Heo GY, Kim HJ, Kang SW, Park JT, Lee E. Insomnia in patients on incident maintenance dialysis and the risk of major acute cardio-cerebrovascular events and all-cause mortality. Nephrology Dialysis Transplantation. 2023 Nov 3:gfad231.
22. Georgianos PI, Agarwal R. Antihypertensive therapy in patients receiving maintenance hemodialysis: A narrative review of the available clinical-trial evidence. Current Vascular Pharmacology. 2021 Jan 1;19(1):12-20.
23. Umeno T, Yamashita A, Mizota T, Uramatsu T, Matsuo T. Predictive value of total small-vessel disease score for recurrent stroke in patients undergoing maintenance hemodialysis. Journal of Stroke and Cerebrovascular Diseases. 2022 May 1;31(5):106400.
24. Chen X, Dong K, Zhou R, Yu X. Mechanism and Research Progress of Danqu Capsule in the Treatment of Maintenance Hemodialysis Complicated with Cardiovascular Disease. MEDS Public Health and Preventive Medicine. 2022 Jun 7;2(3):7-13.
25. Jin YX, Zhang S, Xiao J, Wang ZH, Dong C, You LL, Kuai TT, Zhang Y, Liu SX. Association between serum β2-microglobulin levels and the risk of all-cause and cardiovascular disease mortality in chinese patients undergoing maintenance hemodialysis. BMC nephrology. 2023 Jun 13;24(1):170.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Usman Akbar
District Specialist, DHQ Hospital, Dassu Kohistan – Pakistan
Dr. Suleman Khan
Resident Physician, Medical A Ward, Khyber Teaching Hospital, Peshawar – Pakistan
Dr. Bibi Marrium
Postgraduate Resident, Nephrology Division Khyber Teaching Hospital, Peshawar – Pakistan
Dr. Muhammad Zeeshan Khan
House Officer Khyber Teaching Hospital, Peshawar – Pakistan
Dr. Muhammad Waqas Nabi
House Officer, Nephrology Division Khyber Teaching Hospital, Peshawar – Pakistan
Dr. Faisal Rahim
House Officer Nephrology Division, Khyber Teaching Hospital, Peshawar – Pakistan
Dr. Faizan Banaras
Postgraduate Resident Nephrology Division Khyber Teaching Hospital Peshawar – Pakistan