Analysis Of Influencing Factors Of Arterial Calcification In Pre-dialysis Patients Of Chronic Kidney Disease

Objective The purpose of this study was to analyze the influencing factors of arterial calcification in pre-dialysis patients of chronic kidney disease(CKD).Methods The 337 patients were enrolled, whose were hospitalization with pre-dialysis chronic kidney disease. We collected the basic situation and the biochemical markers which include serum hemoglobin(HGB), albumin(ALB), alkaline phosphatase(ALP), blood urea nitrogen(BUN), creatinine(CR), uric acid(UA), fasting blood glucose(FBG), lipid, calcium(Ca), phosphorus(P), magnesium(Mg), cystatin C?estimated glomerular filtration rate(e GFR), intact parathyroid hormone(i PTH), 24 hours urine protein excretion, C reactive protein(CRP), 25 hydroxy vitamin D3, N-osteocalcin(NOC), bone mineral density(BMD) of lumbar spine and femoral neck. Patients were subdivided into arterial calcification and no arterial calcification, which was aortic calcification or coronary artery calcification(CAC), based on the abdomene X-ray or the spiral CT. Further, we distinguished into four groups: aortic calcification or no aortic calcification and CAC or no CAC. At the same time, we divided all patients into five groups by e GFR: CKD1, CKD2, CKD 3, CKD4 and CKD5.Results Compared to no arterial calcification, arterial calcification had older, more hypertension and chronic nephritis, lower HGB, higher triglycerides(TG) and cystatin C, low e GFR, higher CRP and BMD of femoral neck, which had statistically significant(P?0.05). Compared to no aortic calcification, aortic calcification had older, more hypertension and chronic nephritis, lower HGB and ALB, higher TG and Cystatin C, lower e GFR, higher CRP and BMD of femoral neck, which had statistically significant(P?0.05). Compared to no CAC, CAC had older, more DM, hypertension and chronic nephritis, higher BMI, lower HGB, lowest e GFR, which had statistically significant(P?0.05). According to compare among CKD 1-5 patients, we found following results: First, age, gender, smoking and drinking of patients were no statistically significant(P?0.05), but diabetes mellitus(DM), hypertension and chronic nephritis were statistically significant(P<0.05), the ratio of hypertension was higher significantly after CKD2. Senond, CAC of patients were no statistically significant, however there was more arterial calcification with the progress of CKD. Third, the patients of CKD5 had lower BMI, ALB, Mg, BMD of femoral neck and 25 hydroxy vitamin D3, more anemia, higher UA, N-OC and Cystatin C, lower Ca, higher P and i PTH. Spearman linear analysis showed that, about aortic calcification, TG, low density lipoprotein cholesterol(LDL-C), BUN, CR, Cystatin C had positive correlations. HGB, ALB, e GFR and CRP had negative correlations. About CAC: BUN, CR, Cystatin C, 24-h urine protein excretion had positive correlations. HGB, ALB had negative correlations. About arterial calcification: LDL-C, BUN, CR, Cystatin C, UA and i PTH had positive correlations. HGB, ALB and e GFR had negative correlations. Logistic regression analysis showed that the risk factors of the aortic calcification and or CAC were lower level of HGB, e GFR and N-osteocalcina, higher level of BMI,TG and P, although TG and P were lo-wer relative.Conclusion In pre-dialysis CKD patients, there had widespread 25 hydroxy vitamin D3 deficiency or insufficiency and high incidence of arterial calcification. Lower level of HGB,e GFR and N-osteocalcina, higher level of BMI were the riskfactors of the arterial calcification in pre-dialysis CKD paitents.