International Hospital of Guwahati, India
Mitul Bora has doing his sepicilization in International Hospital of Guwahati located in Inda.
Cardiovascular disease (CVD) is the leading cause of death in the general population and a major cause of morbidity and mortality in chronic kidney disease (CKD) and end stage renal disease (ESRD) patients . The high prevalence of CVD in incident dialysis populations suggests that CVD begins during or before the stage of chronic renal insufficiency. However the cause of the increased in the CVD in patients of CKD including those who are on dialysis is not explained by the traditional risk factors alone. Various nontraditional factors such as hyperhomocysteinemia, hyperparathyroidism, inflammation (indirectly measured with highly selective CRP), acute phase reactants (albumin and fibrinogen), oxidative stress and endothelial dysfunction have all been proposed for this increased incidence of CVD. In fact oxidative stress, endothelial dysfunction, and inflammation represent a key triad serving as the foundation for the development and progression of atherosclerosis. Chronic kidney disease patients, peritoneal and haemodialysis patients, as well as renal transplant patients all show an equal susceptibility in oxidative stress, indicative of a higher degree of inflammatoty activity in these patients. N – acetylcysteine (NAC) serves as an antioxidant by virtue of its interaction with reactive oxygen species. The drug acts on atherosclerosis through several mechanisms including decreased apoptosis, vasoconstriction and endothelial dysfunction