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Kronik Böbrek Yetmezlikli Hastalarda Statinlerin Pleiotropik Etkilerinin Değerlendirilmesi

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Evaluation of Pleiotropic Effects of Statins in Chronic Renal Failure Patients

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Sayfa Aralığı:: 
150-155

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Abstract (Original Language): 
Amaç: Kronik böbrek yetmezlikli hastalarda oksidatif stres, kronik inflamasyon ve endotel işlev bozukluğudan dolayı aterosklerozis daha sık görülür. Kronik böbrek yetmezlikli hastalarda statinler, toplam ve düşük dansiteli lipoprotein (LDL) kolesterolü düşürücü etkilerinin yanında pleiotropik etkileri ile kardiyovasküler olay sıklığını azaltırlar. Biz diyaliz hastalarında statinlerin pleiotropik etkilerinin olup olmadığını araştırmayı amaçladık. GEREÇ ve YÖN TEML ER: Çalışmaya LDL kolesterol düzeyi 130 mg/dl’den yüksek olan 21 diyaliz hastası (12 hemodiyaliz, 9 periton diyalizi) alındı. Atorvastatin titre edilerek 6 ay süreyle verildi. LDL kolesterol düzeyi 100 mg/dl altına indikten sonra oksidize LDL, malondialdehid (MDA), interleukin 6 (IL-6), yüksek duyarlıklı C reaktif protein (ydCRP), fibrinojen, platelet sayısı, sedimentasyon hızı, nitrik oksid (NO), Von Willebrand faktör antijeni (vWF ag), faktör VIII (FVIII) ve homosistein düzeylerini değerlendirdik. BUL GULA R: Atorvastatin tedavisi ile total kolesterol, LDL kolesterol (p<0,001), trigliserid (p<0,05), oksidize LDL (p<0,001), sedimentasyon hızı (p<0,01) ve trombosit sayısında (p<0,05) anlamlı düşme gözlendi. Diğer göstergelerde anlamlı farklılık yoktu. SONU Ç: Atorvastatin diyaliz hastalarında lipid profilinde önemli iyileşme ile oksidize LDL, trombosit sayısı ve sedimentasyon hızında azalma sağlamaktadır.
Abstract (2. Language): 
ObjectI ves : Atherosclerosis is seen more frequently in patients with chronic renal failure (CRF) due to the oxidative stress, chronic inflammation and endothelial dysfunction. Besides lowering total and low density lipoprotein (LDL) cholesterol levels, statins also lower the frequency of cardiovascular incidents in patients with chronic renal failure by their pleiotropic effects. We aimed to investigate whether atorvastatin had pleiotropic effects in dialysis patients. MA TERIAL and metho ds: 21 hyperlipidemic dialysis patients (12 on hemodialysis and 9 peritoneal dialysis) with LDL cholesterol levels over 130 mg/dl were included in this study. Atorvastatin was titrated and given to patients for 6 months. After LDL cholesterol level were reduced to under 100mg/day, we evaluated oxidized LDL, malondialdehyde (MDA), interleukin-6 (IL-6), high sensitive C reactive protein (hsCRP), fibrinogen, platelet count, sedimentation rate, nitric oxide (NO), Von Willebrand factor antigen (vWF ag), factor VIII (FVIII) and homocysteine. Res ults : Significant reductions were obtained in total cholesterol, LDL-cholesterol (p<0.001), triglyceride (p<0.05), oxidized LDL (p<0.001), sedimentation value (p<0.01) and platelet count (p<0.05) with atorvastatin treatment. No differences were seen in the other parameters. ConclusIo n: Atorvastatin is associated with significant improvement of lipid profile and reduction of ox-LDL, platelet count, and sedimentation in dialysis patients.
DOI: 
10.5262/tndt.2011.1002.06

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