Saso Gelev, Goce Spasovski, Sonja Dzikova, Slavcho Tosev, Marjan Bosevski, Gjulsen Selim, Pavlina Dzekova, Arben Asani, Vili Amitov and Aleksandar Sikole
Different Ankle Brachial Index Levels in Asymptomatic Hemodialysis Patients
Resting ankle brachial systolic pressure index (ABI) level of 0.90 is 95% sensitive in detecting angiogram-positive peripheral arterial disease (PAD) and that falsely elevated pressures or incompressible arteries at the ankle level and ABI > 1.30 is caused by mediosclerosis. We evaluated 94 hemodialysis (HD) patients for the presence of PAD and mediosclerosis using ABI measurement, and the presence of atherosclerotic lesions using high resolution B-mode ultrasonography of the common carotid (CCA) and femoral arteries (FA). Asymptomatic HD patients with high ABI (mediosclerosis) and low ABI (PAD) levels were common. Patients with normal and high ABI levels had high percentage of atherosclerotic lesions. Older age, diabetes and low serum albumin, and higher doses of prescribed calcium carbonate were associated (p<0.05) with low levels of ABI in our HD patients. Male gender, higher blood pressure and presence of diabetes were associated (p<0.05) with high ABI levels. Low and high ABI levels were not associated with the specific risks such as elevated serum phosphate, calcium phosphate product and intact parathyroid hormone levels. Arterial disease in asymptomatic HD patients is frequent. Screening for atherosclerotic lesions in HD patients should be recommended even if they had no symptoms.
Momir Polenakovic, Stevka Bogdanovska, Koco Cakalaroski, Sonja Dzikova, Gjorgji Masin, Jelka Masin-Spasovska, Angel Oncevski, Vesna Gerasimovska, Goce Spasovski, Risto Grozdanovski, Olivera Stojceva-Taneva, Ladislava Grcevska, Aleksandar Sikole, Petar Dejanov, Liljana Tozija, Katica Zafirovska, Ninoslav Ivanovski, Ljubica Lozance and Vladimir Pusevski
The fast development of nephrology in the world, especially in the second half of the 20th century demanded protocol (guidelines) for nephrological activity for all levels of medical care, of doctors and specialists. The International Society of Nephrology, the European Renal Association and other national associations created their own protocol (guidelines) for nephrological activity. The Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) proclaimed the First Protocol for Performing Nephrological Activity in the Republic of Macedonia at the First Congress of the MSNDTAO, held in Ohrid 1993, and it was published in the Macedonian Medical Review, 1994; Supplement 14: 397–406 . The update of the Protocol for Performing Nephrological Activity in the Republic of Macedonia was proclaimed at the Fourth Congress of MSNDTAO, held in Ohrid 2012 and it presented in this text.