title: Cardiac evaluation of patients with chronic kidney disease: what lessons?
abstract: BACKGROUND
  Patients with chronic kidney disease (CKD) experiment a synergistic effect of the traditional and the emerging uremia-related risk factors for atherosclerosis.
  
  
  OBJECTIVE
  Draw the epidemiologic profile of a group of CKD patients who underwent cardiac evaluation.
  
  
  METHODS
  Symptomatic patients, patients with ischemia on myocardial scintigraphy and/or systolic dysfunction on echocardiography, patients older than 50 years and diabetes mellitus (DM) as a cause of CKD, and those with two or more risk factors underwent coronary angiography. Asymptomatic, non-diabetic patients and patients with no risk factors were investigated with echocardiography. Those with a single risk factor were investigated with echocardiography and scintigraphy.
  
  
  RESULTS
  46 patients (58.7% men) were enrolled. Their mean age was 50.7 ± 11.7 years. 91.3% were on dialysis, for 61.96 ± 55.1 months. Hypertension was the cause of CKD in 56.5%. Of the 28 patients (60.9%) who underwent angiography, 53.6% had coronary artery disease (CAD). The patients were divided into three groups: those with CAD (A), those without CAD (B) and those who didn't undergo coronary angiography (C). A significant difference occurred only between groups B and C, as regards an abnormal ABI (p = 0.026), with no ABI abnormality in group C, and as regards the mean age, which was higher in group B (p = 0.045). In group A, 53.3% of the patients were in the preoperative stage of parathyroidectomy.
  
  
  CONCLUSIONS
  This study confirmed the high rate of cardiovascular disorders, including CAD, in patients with CKD, especially those on dialysis.
authors.affiliation: Universidade Federal de Pernambuco – UFPE, Brasil .
authors.forename: Andrea
authors.initials: A
authors.lastname: Lordsleem
authors.forename: Ana Paula Santana
authors.initials: AP
authors.lastname: Gueiros
authors.forename: José Edevanilson de Barros
authors.initials: JE
authors.lastname: Gueiros
authors.forename: Brivaldo
authors.initials: B
authors.lastname: Markman Filho
authors.forename: Edgar Guimarães
authors.initials: EG
authors.lastname: Victor
mesh_terms: D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors