Prediction Of Cardiovascular Events By Non-traditional Risk Factors In Patients With Chronic Kidney Disease

Objectives:To explore the changes of clinical indicators in patients with chronic kidney disease during different periods,to understand the occurrence of cardiovascular events in patients with chronic kidney disease,and to further explore the prediction of cardiovascular events by non-traditional risk factors in patients with chronic kidney disease,then to provide new ideas for early prevention and treatment of diseases.Methods:1.A total of 88 patients diagnosed with chronic kidney disease who were admitted to the First Affiliated Hospital of Kunming Medical University from Septem-ber 2018 to January 2019 were randomly selected,including 58 males and 30 females,with an average age of(51.52±15.70);Patients with acute kidney injury,tumor,infecti-on,recent surgical history,concomitant liver disease,primary hyperparathyroidism,multiple myeloma,etc.2.According to the kidney disease diet improvement formula,estimate the glomerular filtration rate,according to the KDOQI guidelines for chronic kidney disease staging,①CKD1 phase GFR>90ml/(min*1.73m2)②CKD2 phase 60<GFR≤90ml/(min*1.73m2)③CKD3 phase 30GFR ≤60ml/(min*1.73m2)④CKD4 phase 15<GFR≤30ml/(min*1.73m2)⑤CKD5GFR≤15ml/(min*1.73m2).the patients with CKD1-3 were divided into group A,CKD stage 4 was divided into group B,CKD5 stage(non-dialysis)was divided into group C,CKD5 stage(hemodialysis)was divided into group D.Patients in group C were divided into mild anemia group according to(HB>90 for mild anemia;90≤HB<60 for moderate anemia;60≤HB<30 for severe anemia,HB<30forextremely severe anemia).Anemia group,severe anemia group;randomness and difference in age and gender between the groups were not statistically significant.3.Collect the patient’s age,gender,primarydisease,past disease history and medication status,height,weight,blood pressure at admission,smoking history,dialysis time,etc.;use Framingham’s 10-year heart disease risk score(Famingham)The atherosclerotic cardiovascular disease risk factor calculation formula(ASCVD)was used to score eligible patients.4.the patient is fasting for about 10 hours in the morning to extract 3～5mL of fasting elbow venous blood(avoid the limbs infusion or blood transfusion before blood collection),2000-3000r/min,centrifugation for 20min,pipette the serum to the sample In the storage tube,stored in a refrigerator at-20℃,the Klotho protein content in the blood of the patient was detected by ELISA;the laboratory data of the patients in the group were collected:blood routine,liver function,renal function,electrolyte,anemia related test,thyroid Parathyroid hormone,etc.;imaging examination data:cardiac ultrasound,cervical vascular ultrasound.Results:1.A,B,C,D four groups of indicators,compared with L%,HB,RDW,P,CA*P,ALB,LVEF,NLR,CA,PTH,Mg,GGT differences between the groups(P<0.05).2.There was significant difference in RDW,age and TRF between the two groups compared with the non-valvular calcification group(P<0.05).However,in the analysis of risk factors of valvular calcification,the two-category logistic regression analysis indicated the age.Correlation with valve calcification(P<0.01).The changes of SBP,RDW and Klotho were correlated with Famingham score(P<0.05).The change of SBP was correlated with ASCVD score(P<0.01).The change of RDW was correlated with CIMT(P<0.05).4.Correlation analysis showed that LVDd was positively correlated with PTH,Mg,BUN and TRP(P<0.05),among which PTH was the strongest(r=0.261),negatively correlated with TC(P<0.05);LVEF was negatively correlated with PTH,Correlation was positively correlated with TG(P<0.05);IVST was positively correlated with BMI,PLR,NLR,RDW,UA,GGT,N%(P<0.05),and N%was the strongest(r=0.340).There was a negative correlation with L%(P<0.05);LVPWT was positively correlated with PLR,NLR,PTH,N%(P<0.05),and the correlation with NLR was the strongest(r=0.322),and negatively correlated with L%(P<0.05).P<0.05);E/A was positively correlated with Mg(P<0.05),and negatively correlated with PLR,RDW and UA(P<0.05),and the correlation with RDW was the strongest(r=-0.274).5.There was no significant difference in klotho protein between the four groups A,B,C and D(P>0.05).In group C,correlation analysis indicated that there was no correlation between klotho protein and Ca,P,CA*P,PTH,TG,TC,HDL-L,and LDL-L(P>0.05).In group C,there was no significant difference in HB between mild anemia,moderate anemia and severe anemia(P>0.05).There was no correlation between anemia and klotho protein(P>0.05).Conclusions:1.L%,HB,RDW,NLR,P,CA,CA*P,PTH,Mg,ALB,LVEF,GGT indicators of CKD patients may change with GFR changes,and can be used as an indicator of the progress of renal function.2.1n the analysis of risk factors for valvular calcification,age is a risk factor for valvular calcification.3.SBP,Klotho protein in patients with CKD is a risk factor for patients with Famingham score and ASCVD score;RDW is a risk factor for carotid intima thickness.4.Klotho protein in patients with CKD and GFR,calcium and phosphorus metabolism disorders,blood lipids,anemia,no significant correlation.5.GGT,Mg,NLR,N%,L%,PLR,RDW are associated with cardiac structure and functional impairment,suggesting that the above indicators can be used to predict the occurrence of cardiovascular events in patients with chronic kidney disease.