Characteristics of Revascularization Treatment for Arteriosclerosis Obliterans in Patients With and Without Hemodialysis
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概要
- 論文の詳細を見る
Background: Limb ischemia is a major complication in patients who are receiving hemodialysis (HD). In this study, distinctive features and factors affecting the outcome of HD patients with limb ischemia are identified. Methods and Results: One hundred and eighty consecutive symptomatic limb ischemic patients who were or were not receiving HD and who successfully underwent surgical bypass grafting (bypass, n=75) or endovascular angioplasty (percutaneous transluminal angioplasty (PTA), n=105) were retrospectively compared at our hospital. The endpoint of this study was amputation of the ischemic leg or death. Median follow up was 2.25 years. The amputation-free survival of HD patients was significantly lower than that of non-HD patients (P<0.0001). In the bypass group, the amputation-free survival of HD patients was significantly lower than that of non-HD patients (P=0.0002), even if the graft was patented or not (P=0.77). In contrast, in the PTA group, the amputation-free survival of HD patients was lower than that of non-HD patients (P=0.03), and with a significantly lower patency rate (P=0.0004). Predictors of amputation-free survival differed between HD and non-HD patients; predictors were diabetes mellitus and gender in HD patients, while they were Fontaine classification and hyperlipidemia in non-HD patients. The infectious death rate was higher in HD patients than in non-HD patients (53% vs 22%, P<0.05). Conclusions: This study clearly showed a poorer prognosis in HD patients than in non-HD patients especially after bypass surgery, even if the the graft was patented or not. (Circ J 2010; 74: 2426-2433)
- 2010-10-25
著者
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YAMAGATA Kunihiro
Department of Nephrology, Institute of Clinical Medicine, Graduated School of Comprehensive Human Sc
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Ubara Yoshifumi
Nephrology Center, Toranomon Hospital
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Suwabe Tatsuya
Nephrology Center, Toranomon Hospital
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Sawa Naoki
Nephrology Center, Toranomon Hospital
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Takemoto Fumi
Nephrology Center, Toranomon Hospital
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Takaichi Kenmei
Nephrology Center, Toranomon Hospital
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Fujimoto Yo
Cardiovascular Center Toranomon Hospital
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Ishiwata Sugao
Cardiovascular Center Toranomon Hospital
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Ohno Minoru
Cardiovascular Center, Toranomon Hospital
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Sawa Naoki
虎の門病院腎センター
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Sawa Naoki
Nephrology Center Toranomon Hospital
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Takemoto Fumi
Nephrology Center Toranomon Hospital
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Suwabe Tatsuya
Nephrology Center Toranomon Hospital
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Fujimoto Yo
Department Of Cardiovascular Center Toranomon Hospital
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Fujimoto Yo
Department Of Cardiovascular Center Medicine Toranomon Hospital
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Ohno Minoru
Department Of Cardiology Toranomon Hospital
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Naruse Yoshihiro
Cardiovascular Center, Toranomon Hospital
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Hoshino Junichi
Nephrology Center, Toranomon Hospital
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Ubara Yoshifumi
Nephrology Center Toranomon Hospital
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Takaichi Kenmei
Nephrology Center Toranomon Hospital
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Hasegawa Eiko
Nephrology Center Toranomon Hospital
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Ishiwata Sugao
Department Of Cardiovascular Center Medicine Toranomon Hospital
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Ohno Minoru
Cardiovascular Center Toranomon Hospital
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Yamagata Kunihiro
Department Of Nephrology Graduate School Of Comprehensive Human Science University Of Tsukuba
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Naruse Yoshihiro
Cardiovascular Center Toranomon Hospital
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Hoshino Junichi
Nephrology Center Toranomon Hospital
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Ubara Yoshifumi
Nephrology Center Toranomon Hospital Kajigaya
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Suwabe Tatsuya
Nephrology Center Toranomon Hospital Kajigaya
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Yamagata Kunihiro
Department Of Nephrology Division Of Clinical Medicine University Of Tsukuba
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Ishiwata Sugao
Cardiovascular Center, Toranomon Hospital
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Hasegawa Eiko
Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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Sawa Naoki
Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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Ubara Yoshifumi
Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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Suwabe Tatsuya
Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
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