RESUMO
In the context of metabolic alteration in dialysis patients the Authors have studied the characteristics, incidence, pathogenesis, effect of dialysis, atherogenic risk and therapeutic approach to hyperlipemia in hemodialysis patients. Hypertriglyceridemia secondary to reduced lipolytic activity is the most frequent alteration observed in hemodialytic patients (36.7% of cases). In addition, hemodialysis reduces the levels of lipoprotein in the blood whereas the atherogenic role of hyperlipemia does not appear to be as important as that of arterial hypertension and smoking. Simvastatin breaks down the lipidic fractions which are involved in atherogenesis and coronary cardiopathy, thus acting as a valuable prevention against cardiovascular involvement in dialysis.
Assuntos
Hiperlipidemias/etiologia , Diálise Renal , Adulto , Idoso , Arteriosclerose/etiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Feminino , Humanos , Hiperlipidemias/tratamento farmacológico , Hiperlipidemias/epidemiologia , Hiperlipidemias/fisiopatologia , Incidência , Lipólise , Lipoproteínas/sangue , Lovastatina/análogos & derivados , Lovastatina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Sinvastatina , Fumar , Uremia/complicações , Uremia/terapiaRESUMO
A kinetic evaluation of dialytic methods using a diffusive-convective mechanism in comparison to the standard bicarbonate dialysis was performed in order to verify the possible therapeutic uses. The "kinetic" comparison of PFD and HDF to HBD, using equal quantities of dialysate, showed no significant change in the mention of uremic toxins of small molecular weight and a more efficient capacity to extract beta 2M by the diffusive-convective methods. The biophysical evaluation of dialysis still appears to represent the best means of defining the clearance possibilities and of identifying the most suitable technique for achieving a dialytic adequacy.