Analysis Of Cardiovascular And Cerebrovascular Deaths In End-stage Renal Disease Patients Undergoing Maintenance Hemodialysis

Objective:To investigate the risk factors of cardiovascular and cerebrovascular deaths in end-stage renal disease patients undergoing maintenance hemodialysis(MHD).Methods:We collected the clinical data of uremia patients undergoing MHD who died from January 2009 to December 2016 at the First Affiliated Hospital of Chongqing Medical University.We excluded patients who died of accidental deaths,such as suicide and trauma,who did not undergo regular hemodialysis treatment,and who had incomplete clinical data.Finally,we retrospectively analyzed 121 patients.Results:Among the 121 patients,71 males and 50 females had the most common cause of death from diabetic nephropathy(n=42),followed by hypertensive nephropathy(n=35),and chronic glomerulonephritis(n=18).The main causes of death were cardiovascular disease(n=24),cerebrovascular disease(n=23),and respiratory disease(n=28).The mortality of cardiovascular disease was significantly higher in patients with high blood phosphorus(>1.45 mmol/L)and vascular calcification than those in the normal blood phosphorus group(≤1.45 mmol/L),and in the nonvascular calcification group,the difference was statistically significant.Compared with those who did not die of cardiovascular and cerebrovascular diseases,the incidence of diabetes mellitus and vascular calcification,the levels of blood phosphorus and low-density lipoprotein were significantly higher in patients who died of cardiovascular and cerebrovascular diseases;meanwhile,the difference was statistically significant.A logistic regression analysis showed that high blood phosphorus and vascular calcification were risk factors for death in MHD patients.Conclusion:Cardiovascular and cerebrovascular diseases are the most important causes of death in MHD patients,followed by respiratory failure and infection.The higher blood phosphorus levels and vascular calcification are risk factors for mortality results of cardiovascular and cerebrovascular diseases.Controlling blood phosphorus levels and improving mineral bone metabolism can help reduce the mortality in MHD patients.