Coronary artery disease treatment in dialysis patients at the Hospital das Clínicas da Faculdade de Medicina de Botucatu--UNESP.
BACKGROUND
Interventional treatment of coronary insufficiency is underemployed among dialysis patients. Studies confirming its efficacy in this set of patients are scarce.


OBJECTIVE
To assess the results of interventional treatment of coronary artery disease in patients undergoing dialysis.


METHODS
A total of 34 dialysis patients submitted to coronary angiography between September 1995 and October 2004 were divided according to presence or absence of coronary lesion, type of treatment and presence or absence of diabetes mellitus. The groups were compared according to their clinical and survival characteristics. Survival of patients undergoing interventional treatment was compared to overall survival of 146 dialysis patients at the institution in the same period. Interventional treatment was indicated to the same clinical conditions in the general population.


RESULTS
Thirteen patients with no angiography coronary lesions presented a survival rate of 100% in 48 months as compared to 35% of 21 patients with coronary artery disease. Diabetic patients had a lower survival rate compared with non-diabetics. Angioplasty had a worse prognosis compared to surgery; however, 80% of patients undergoing angioplasty were diabetic. Seventeen patients submitted to interventional procedures presented a survival rate similar to that of the others 146 hemodialysis patients without clinical evidence of coronary disease.


CONCLUSIONS
This small series shows that myocardial revascularization, whenever indicated, can be performed in dialysis patients. This conclusion is corroborated by similar mortality rates in two groups of patients: coronary patients submitted to revascularization and overall dialysis patients.
Vieira
Paula Ferreiro
PF
Faculdade de Medicina de Botucatu, UNESP, Botucatu, SP, Brazil.
Garcia
Paula Dalsoglio
PD
Bregagnollo
Edson Antonio
EA
Carvalho
Fábio Cardoso
FC
Kochi
Ana Cláudia
AC
Martins
Antonio Sérgio
AS
Caramori
Jaqueline Costa Teixeira
JC
Franco
Roberto Jorge da Silva
RJ
Barretti
Pasqual
P
Martin
Luis Cuadrado
LC
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis; D016896:Treatment Outcome