Analysis Of Cardiovascular Risk Factors And Causes Of Death In Maintenance Hemodialysis Patients

Objective:We selected 229 patients undergoing maintenance hemodialysis(MHD)treatment in blood purification center of Shenyang Fourth People’s Hospital,between January 1,2013 and June 30,2015.The treatment time of all MHD patients were more than 3 months.To analyze the composition of the original disease,the characteristics of cardiovascular disease,the cause of death,in order to facilitate the clinical prevention and treatment of MHD.Methods: Selection on January 1,2013-June 30,2015 in Shenyang Fourth People’s Hospital of blood purification center received maintenance hemodialysis treatment,a total of 229 cases.Statistics MHD patients general information and 2 times a year laboratory data,1 times a month follow-up,recorded in patients with cardiovascular disease,the death of patients with data collected before the death of the examination results.General information of patients: primary disease,gender,age,height,weight,body mass index(mass index BMI body),dialysis age,etc.Laboratory data: hemoglobin,cholesterol,triglyceride,low density lipoprotein cholesterol,calcium,phosphorus,albumin and uric acid,creatinine,urea,C-reactive protein,cystatin-C and so on.Grouping method :(1)According to the occurrence of serious cardiovascular disease,the patients(n=161)were divided into cardiovascular disease group(n=50)and non cardiovascular disease group(n=111).Cardiovascular disease refers to acute myocardial infarction,heart failure.Compared with the data of two groups,the risk factors of cardiovascular disease were discussed.(2)According to the MHD patients with different primary disease,the patients were divided into diabetic nephropathy(n=93),hypertensivenephropathy(n=36),chronicglomerulonephritis(n=50),interstitial nephritis(n=31),polycystic kidney disease,obstructive nephropathy and other nephropathy group(n=19).Calculate the proportion of different primary diseases,comparison of different primary onset age and age of onset of dialysis.(3)Analysis of all death cases,analysis of the causes of death in patients with MHD,analysis of the relationship between the patient’s death and the dialysis age.All cases of death(n=68)as the research object,all survival group patients(n=161)as the control group,compared with the two groups of patients with clinical indicators of differences.Results: In the study included 229 MHD patients,119 male,110 female,mean age 61.56±12.86 years,follow-up time was 2.5 years,68 patients died and 161 patients survived.Cardiovascular disease occurred in 77 patients,the total incidence rate of cardiovascular disease was 33.62%.(1)Analysis of cardiovascular risk factors in patients with MHD: Were compared between the two groups in gender,BMI,serum calcium,duration of dialysis,urea,uric acid,C-reactive protein had no significant difference,the cardiovascular disease patients age,cholesterol,low-density lipoprotein cholesterol,Cystatin-C level is higher than that of the non cardiovascular disease group.Cardiovascular disease patients in the hemoglobin level is lower than the non cardiovascular disease group.(2)MHD patients with primary disease statistics indicated that diabetic nephropathy is our center of MHD patients most primary disease(40.61%)and other primary disease followed by chronic glomerulonephritis(21.83%),hypertensive nephropathy(15.72%),interstitial nephropathy(13.53%),polycystic kidney disease,obstructive nephropathy and other nephropathy(8.29%).Time of dialysis patients with diabetic nephropathy were lower than the other groups.(3)In the study of death patients,we found that in the dialysis age,the first year after dialysis is the peak of death,41.17% patients died in the first two years of dialysis.On the cause of death,the proportion of cardiovascular diseases was 39.71%,the proportion of serious infection was 13.24%,the proportion of sudden death and unknown causes was 22.06%.Cardiovascular disease remains the leading cause of death.In the death group as the research object,survival group as control group,compared two groups of patients,death in the group of patients with hemoglobin,albumin and cholesterol levels lower than the control group.Age,C-reactive protein and serum cystatin-C higher than control group.Conclusion: In my blood purification center,diabetic nephropathy is the most common primary disease of MHD patients,followed by chronic glomerulonephritis.The survival time was shorter in patients with diabetic nephropathy.The incidence rate of cardiovascular disease was.33.62%.Age increase,low hemoglobin,high cholesterol and high LDL-C and high levels of cystatin-C are risk factors for cardiovascular disease.Cardiovascular disease is the first cause of death in patients with MHD.Death in patients with hemoglobin,albumin and cholesterol levels lower than the survival of patients,while age,C-reactive protein and serum cystatin-C higher than the survival of patients.