RESUMO
BACKGROUND AND AIMS: Vascular calcification (VC) is a predictor of poor survival and cardiovascular outcome in end-stage renal disease (ESRD) patients; however, there is scarce information of VC in Latin America, and virtually no data in our setting. We undertook this study to evaluate the prevalence and characteristics of VC in a hemodialysis (HD) population from western Mexico and to determine possible associated factors. METHODS: This was a cross-sectional study performed in 52 patients. VC was evaluated using plain X-ray films (Adragao's score) of hands and pelvis; clinical and biochemical variables were also collected. Statistical analysis was carried out with Student t and χ(2) tests performed as appropriate and logistic regression to determine predictors of VC. RESULTS: Mean age was 43 years, 48% were female, 23% had diabetes mellitus (DM), and median time on dialysis was 46 months. Percentage prevalence was 52% with a mean calcification score of 2.0 ± 2.6; 23% of patients had severe calcification. VC was present in about 23-37% among the different vascular territories evaluated (radial, digital, femoral and iliac). Patients with calcification were significantly older, had a higher frequency of DM, higher alkaline phosphatase and lower HDL lipoproteins than those without VC. In the multivariate analysis, VC in these patients was significantly predicted only by an older age (OR [95% CI]: 1.15 [1.01-1.31], p = 0.04); lower HDL-cholesterol and higher alkaline phosphatase were marginal predictors. CONCLUSIONS: Half of our HD patients had VC. Territories of radial, iliac, femoral and digital arteries were roughly equally affected, and 25% of patients had a calcification considered as severe. Older age was the only significant predicting variable for VC, with low HDL-cholesterol and high alkaline phosphatase as marginal predictors.
Assuntos
Calcinose/fisiopatologia , Diálise Renal , Calcificação Vascular/fisiopatologia , Adulto , Idoso , Calcinose/epidemiologia , Calcinose/etiologia , Estudos Transversais , Feminino , Humanos , Falência Renal Crônica , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Prevalência , Artéria Radial/fisiopatologia , Calcificação Vascular/epidemiologia , Calcificação Vascular/etiologiaRESUMO
Entre el 1§ de marzo de 1995 y el 30 de marzo de 1996, se efectuaron 21 biopsias pulmonares a igual número de pacientes con nódulos y neoformaciones pulmonares sospechosas de malignidad, por datos clínicos y de la imagen radiológica. Los pacientes del sexo masculino fueron los más afectados por neoplasias (72 por ciento) y la sexta década de la vida fue la mas frecuente, el diagnóstico citológico mas numeroso fue el carcinoma epidermoide en 12 pacientes. Veinte lesiones fueron periféricas y en un sólo paciente fue de tipo central, cercana al mediastino. En 19 pacientes (90.4 por ciento), obtuvimos un diagnóstico citológico, en dos (9.52 por ciento el procedimiento fue fallido, ambos por tener lesiones pequeñas (1.8 cm). Dos pacientes tuvieron como complicación del procedimiento, neuromotórax, que requirió manejo con sello de agua (9.52 por ciento). Este procedimiento fue eficaz para dar el diagnóstico citológico en 19 pacientes