Related Factors Of Serum 25-hydroxy Vitamin D₃ And Correlation Between 25 Hydroxy Vitamin D₃ With Cardiac Valvular Calcification In Chronic Kidney Disease Patients Stage 3-5

Objective(1)To detect the deficiency of 25-hydroxy vitamin D3 [25(OH) D3] in chronic kidney disease(CKD) patients stage 3-5;(2)the 25(OH) D3 level、deficiency of CKD patients and healthy control group, analyze the factors of serum 25(OH) D3;(3) association between serum 25(OH)D3 and cardiac valvular calcification(VC).Methods213 CKD patients stage 3-5 were collected, and excluded in the period of acute infection, malignant tumor, acute liver failure, acute renal failure and parathyroids resection patients, to meet the conditions of all patients were recorded gender, age,blood pressure, diabetes, hypertension, smoking drinking history, body massindex(BMI), laboratory examinations of routine blood test, serum creatinine, urea nitrogen, albumin, totalcholesterol, calcium, phosphorus, 25(OH) D3, intact parathyroid hormone(i PTH), and lateralradiograph of the abdomen, echocardiography and other auxiliary examination.In the physical examination center for health examinationof the history of 176 cases of non kidney disease as a controlgroup, To compare the differences between CKD and control group serum 25(OH) D3 levels and the lack of rates, and to analyze the factors that influence the lack of25(OH)D3 in patients with CKD stage 3-5.To detect association between serum 25(OH)D3 and VC, 294 patients with CKD stages 3-5 were included, according to the presence of VC is divided into calcification group and non calcification group, compared two groups of patients with general demographic characteristics, clinical features, laboratory indicators differences; diagnose for the VC as outcome variables, the demographic characteristics, clinical features and laboratory examination indexes as the independent variable, binary logistic regression model was established, find VC related risk factors, relationship between 25 (OH) D3 and VC.Results 1. Selected 213 CKD patients with patients, mean age(53.7 ±15.6) years, 25(OH) D3 deficiency rate was 77.9%;2. CKD group of 25(OH) D3 level lower than that the control group(10.8± 8.3) ng / ml vs 14.7±6.5) ng / ml, P < 0.01, CKD group of 25(OH) D3 deficiency rate is higher than that of the control group(77.9% vs 54.6%, P < 0.01).3. The single factor correlation analysis showed that 25(OH) D3 and hemoglobin(HB), albumin(ALB), i PTH, alkaline phosphatase(ALP), estimated glomerular filtration rate(e GFR) had a positive correlation(P < 0.05), and systolic blood pressure(SBP), total cholesterol(TC) showed a negative correlation(P < 0.05).4. The incidence of VC was 27.9%(82/294) and non-VC was 72.1%(212/294). The level of 25(OH)D3 was 11.9±9.3 ng/mland 9.6±7.2 ng/ml in VC group and non-VC group respectively(P<0.05). Compared to non-VC group, the level and incidence of i PTH, Cystatin C, 25(OH)D3, pulmonary artery pressure(PAP) and abdominal aorta calcification were significantly higher; e GFR was significantly lower(P<0.05).Binary logistic regression analysis indicated that advanced age, high parathyroid hormone, high level 25(OH) D3, Pulmonary arterial hypertension is a risk factor for VC.Conclusion 1 CKD3-5 patients and healthy people generally have 25(OH) D3 deficiency, CKD patients are more seriously, 25(OH)D3was positively correlated with Hb, Alb, i PTH, ALP and e GFR, 25(OH)Dwas negatively correlated with SBP, TC; which ALB, TC and ALP were the independent influencing factors.2. CKD stages 3 to 5 patients with VC occurred rate high, advanced age, high parathyroid hormone, high level 25(OH) D3, Pulmonary arterial hypertension is a risk factor for VC.