Analysis Of The Relationship Between Mineral Bone Disorder And Cardiac Damage In Middle-Late Stage Patients Of Chronic Kidney Disease

Objectives: To analyze the relationship between mineral bone disorder and cardiac damage in middle-late stage patients of chronic kidney disease. Methods: 125 cases of chronic kidney disease(CKD) stage 3-5 were retrospectively collected who performed in the First Affiliated Hospital of Fujian Medical University from January 2013 to February 2014. They were divided into three groups according to CKD stage, and the patients who were in CKD5 stage group were divided into CKD5 sub-group and CKD5 D sub-group according to whether dialysis(hemodialysis or peritoneal dialysis) or not. LAD、LVDd、LVDs、IVST、LVPWT、FS、EF、LVM、PVE、PVA were measured by ultrasonic cardiogram.LVMI and E/A were calculated by the equation. The serum creatinine, blood urea nitrogen(BUN), serum calcium, serum phosphorus, parathyroid hormone(PTH), N-terminal peptide of typeⅠprocollagen(TP1NP), β-C-terminal telopeptide of typeⅠcollagen(β-CTX), N-MID osteocalcin(N-MID), 25(hydroxyl)vitamin D3(25-(OH)VD3) were detected at the time to analyze the related cause of LAH, left ventricular diastolic and systolic dysfunction. Results: As chronic kidney disease worsen from CKD4 stage to 5 stage, the level of serum phosphorus, PTH, β-CTX, N-MID rise obviously, and LVDd, LVDs, LVPWT, LVMI enlargement obviously, but EF and FS which stand for left ventricular systolic function descend obviously. For linear analysis, LVMI, E/A, FS were used as the dependent variable in turn, and serum calcium, serum phosphorus, PTH, TP1 NP, β-CTX, N-MID were as independent variables, the results showed that LVMI were negatively correlated with serum calcium(P<0.05),but were positively correlated with serum phosphorus, PTH, N-MID, β-CTX(P < 0.05). E/A were positively correlated with N-MID(P<0.05). EF were positively correlated with TP1NP(P<0.05). At the same time, for Logistic regression analysis, LVMI, E/A, FS were used as the dependent variable in turn, and 25-(OH)VD3 were as independent variable, the result showed that the shortage of 25-(OH)VD3 was single dangerous factors of the dysfunction of left ventricular in CKD patients. Multiple regression analysis showed that age, systolic pressure, hemoglobin have an influence on LVMI. Age and diastolic pressure have an influence on E/A, Age and TP1 NP have an influence on EF. Conclusions: The increasing of the level of serum phosphorus, serum calcium,PTH, 25-(OH)VD3 and some of the marker of the transformation of bone were one of significant influencing factor of the structure and(or) function of left ventricular in middle-late stage patients of chronic kidney disease.