Correlative Risk Factors Analysis Of Vascular Calcification In Patients With End Stage Renal Disease

Objective:To investigate the status and the risk factors of vascular calcification in patients with end stage renal disease.Methods:The clinical data in maintenance hemodialysis patients(MHD)and predialysis CKD stage 5 patients were analyzed retrospectively,respectively.Part 1.The reports of 155 cases were collected in predialysis CKD stage 5 treated in Fuzhou General Hospital from Jan 2015 to Jan 2016.The patients were divided into coronary artery calcification group and non-coronary artery calcification group according to the chest CT scan results.The basic clinical characteristics and laboratory examination indexes were collected,such as serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone(iPTH),etc,meanwhile,calcium-phosphorus product and correction of serum calcium were calculated.The differences of clinical biochemical indexes between the two groups were analyzed,moreover,these factors which had statistical significances were analyzed by univariate factor logistic regression analysis.Part 2.The reports of 118 cases were collected in maintenance hemodialysis patients treated in Fuzhou General Hospital from Jan 2015 to Dec 2016.The analysis methods were the same as the first part.Results:In 155 patients with non-dialyzed CKD stages 5 including calcification group(n=58)and non-calcification group(n=97),the incidence of coronary artery calcification(CAC)was 37%.There were significant differences in age,hypertension history,diabetes history,25-hydroxy vitamin D,albumin and high-density lipoproteins between the two groups(P<0.05).Moreover,these factors which have statistical significances were analyzed by univariate factor logistic regression analysis.The results showed that age(OR=1.174,P<0.01)and hypertension history(OR=3.737,P<0.05)were the independent risk factor favoring the occurrence of coronary artery calcification(CAC);normal level of high-density lipoproteins(OR=0.247,P<0.05)was the protective factor preventing the occurrence of CAC.In 118 patients in maintenance hemodialysis including calcification group(n=73)and non-calcification group(n=45),the incidence of coronary artery calcification(CAC)was 62%.Compared to the non-dialyzed patients with CKD stage 5,the incidence of coronary artery calcification had significant difference.There were significant differences in age,hemodialysis vintage,albumin,correction of serum calcium,serum phosphorus,calcium-phosphorus product and high-density lipoproteins between the two groups(P<0.05).Logistic regression analysis showed that age(OR=1.099,P<0.01)and hemodialysis vintage(OR=1.032,P<0.01)were the independent risk factor favoring the occurrence of CAC;normal level of high-density lipoproteins(OR=0.282,P<0.05)was the protective factor preventing the occurrence of CAC.Conclusion:1.Vascular calcification is more common in maintenance hemodialysis patients,compared to the non-dialyzed patients with CKD stage 5.2.In non-dialyzed patients with CKD stage 5:age,hypertension history,diabetes history,25-hydroxy vitamin D,albumin and high-density lipoproteins levels are associated with VC.Age and hypertension history are the independent risk factors for VC;while normal level of high-density lipoproteins is the protective factor for VC.3.In maintenance hemodialysis patients:age,hemodialysis vintage,albumin,correction of serum calcium,serum phosphorus,calcium-phosphorus product and high-density lipoproteins levels are associated with VC.Age and hemodialysis vintage are the independent risk factors for VC;while normal level of high-density lipoproteins is the protective factor for VC.