| Objective To investigate the prevalence and control of chronic kidney disease-minerals and bone abnormalities(CKD-MBD)in maintenance dialysis patients in a single dialysis center,the distribution of bone mineral density,and the occurrence of vascular calcification in peritoneal dialysis and hemodialysis patients.To explore the incidence of vascular calcification and analysis of risk factors in dialysis patients.Methods A single center cross-sectional study.A total of 155 patients undergoing regular dialysis treatment for 3 months or more were enrolled during the January 2017 to October2017 in the Dialysis Center of the Municipal Hospital of Qingdao,Shandong Province.There were 40 patients with continuous ambulatory peritoneal dialysis(CAPD)and 115 patients with maintenance hemodialysis(MHD).The general data of patients with CAPD and MHD were collected,and serum calcium,serum phosphorus,intact parathyroid hormone(i PTH)and other biochemical indicators were measured and statistical standards were achieved.Coronary Artery Calcification Score(CACS)was assessed with multi-slice spiral computed tomography.Abdominal Aortic Calcification Score(AACS)was assessed with lateral plain radiograph of the abdomen.Bone Mineral Density(BMD)was assessed with the dual energy X-ray absorptiometry.Binary logistic regression was used to analyze the related risk factors of vascular calcification.Results 1.Sixteen cases of the CAPD patients were male(40.00%),the average age was(67.18±14.18)years old and the average dialysis age was(22.84±19.17)months.Among the CAPD patients,17 cases had the major primary disease of diabetic nephropathy(42.50%),12 cases of hypertensive nephropathy(30.00%),11 cases of chronic glomerulonephritis(27.50 %).In the CAPD patients,10 cases had the lanthanum carbonate taken history(25.00%)and 18 cases had calcium carbonate / calcium taken history(45.00%).Seventy-one cases of the MHD patients were male(61.74%),the average age was(58.43±14.19)years old and the median dialysis age was 35(13.10,78.16)months.Among the MHD patients,37 cases had the major primary disease of chronic glomerulonephritis(32.17%).,34 cases of hypertensive nephropathy(29.57%),34 cases of diabetic nephropathy(29.57%),7 cases of polycystic kidney(6.09%),2 cases of lupus nephropathy(1.74%),1 cases of allergic purpura nephritis(0.87%).In the MHD patients,11 cases had the lanthanum carbonate taken history(9.57%)and 52 cases had calcium carbonate / calcium taken history(45.22%).2.The serum calcium standards of patients in the CAPD group and MHD group were 75.00% and 54.78%,respectively.Serum phosphorus compliance rates were 60.00% and 31.30%.i PTH compliance rates were55.00% and 58.26%.The total control rates of serum calcium,serum phosphorus and i PTH were 25.00% and 15.65%.There was a statistical difference between the two groups in the rates of serum calcium and serum phosphorus.3.The incidence of hypercalcemia in the MHD group was significantly higher than that in the CAPD group(21.74%vs7.50%,P<0.05).The incidence of hyperphosphatemia in the MHD group was significantly higher than that in the CAPD group(57.39%vs32.50%,P<0.05).There was no significant difference in the incidence of low i PTH and high i PTH between the two groups(27.50%vs22.61%,7.50%vs19.13%,P>0.05).4.In the CAPD group,38 patients(95.00%)met the diagnosis criteria of CKD-MBD.In the MHD group,113 patients(98.26%)met the diagnosis criteria of CKD-MBD.There was no statistical difference between the two groups in the prevalence of CKD-MBD.5.The incidence of CKD-MBD with low bone mineral density between the CAPD group and the MHD group was 80.00% and 88.69%respectively.There was no statistical difference between the two groups in the incidence of CKD-MBD with low bone mineral density.6.The incidence of abdominal aortic calcification in the CAPD group and in the MHD group was 90.00% and 91.30%,respectively.There was no statistical difference in the incidence of total calcification of abdominal aorta.The incidence of mild calcification of abdominal aorta in the MHD group was significantly higher than that in the CAPD group(41.74% vs15.00%,P<0.05).The incidence of moderate abdominal aorta in the CAPD group was significantly higher than that in the MHD group(67.50% vs31.30%,P<0.05).the CAPD group and the MHD group had statistically significant differences in the incidence of mild to moderate calcification of abdominal aorta.7.The incidence of coronary artery calcium in the CAPD and in the MHD groups was 85.00% and 80.00%,respectively.There was no significant difference in the incidence of coronary artery calcification between the two groups.8.Using binary logistic regression analysis showed that the age of patients with CAPD was an independent risk factor affecting coronary artery calcification(OR = 1.132)and abdominal aortic calcification(OR= 1.169).In MHD patients,age(OR = 1.060)and age of dialysis(OR = 1.040)were independent risk factors for coronary artery calcification and age(OR = 1.180)was an independent risk factor for abdominal aortic calcification.Conclusion This study showed that the CAPD patients were higher than the MHD patients in terms of serum calcium and serum phosphorus compliance rates,CKD-MBD was prevalent in this dialysis patients,and the incidence of CKD-MBD with low bone density and the problem of vascular calcification was universal.Old age and long-term dialysis were risk factors for vascular calcification in dialysis patients. |
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