The Distribution Of Abdominal Aortic Calcification And Its Influencing Factors In CKD Patients With Stage 3-5

Objective:The objective of the study is to investigate the distribution of abdominal aortic calcification(AAC)in patients with stage CKD3-5 who did not enter maintenance hemodialysis(MHD)and the correlation between the general data of patients,laboratory indexes and the severity of abdominal aortic calcification.Methods:From January 2016 to December 2017,we collected 63 patients with stage CKD3-5who did not enter maintenance hemodialysis(MHD)in the Department of Nephrology,Shanxi Provincial People's Hospital.We recorded their age,height,weight,history of hypertension,and history of diabetes,collected their serum calcium(Ca),serum phosphorus(P),albumin,serum creatinine(SCr),blood urea nitrogen(BUN),uric acid(UA),triglyceride(TG),total Total laboratory cholesterol(TC),low-density lipoprotein cholesterol(LDL),high-density lipoprotein cholesterol(HDL),and fasting blood glucose for statistical analysis.According to abdominal CT plain scan,we determined AAC evaluation grade and divided the patients into four groups: AAC 0,AAC 1,AAC 2 and AAC 3.AAC evaluation grade was performed by abdominal CT plain scan and the patients were divided into four groups: AAC 0,AAC 1,AAC 2 and AAC 3.Results:1.We enrolled 63 patients with CKD3-5 hospitalized in our Department of Nephrology in the study,including 39 males(61.9%)and 24 females(38%),with mean age 64.4±22.6(range=24-87).There were 20 patients with CKD3,22 patients with CKD4,and 21 patients with CKD5.There were no significant differences in height,weight,and BMI among the CKD patients.2.BMD was negatively orrelated with AAC(r=-0.46,P<0.001).Among the enrolled patients,there were 13 patients with grade AAC 0,27 patients with grade 1,19 patients with grade 2,and 4 patients with grade 3.The severity of abdominal aortic calcification(AAC)in patients with stage CKD5 is heavier than that in patients with stage CKD3 and the AAC in patients with stage CKD4 is heavier than that in patients with stage CKD3 too.We have not found a difference in the severity of abdominal aortic calcification in patients with CKD4 and CKD5.3.In the biochemical indicators of patients with stage CKD3-5,serum calcium levels gradually decreased in patients with CKD3,4,and 5 stages,and blood phosphorus levels gradually increased.Fasting blood glucose levels in CKD5 patients are higher than those in CKD4 and CKD3.4.The age of AAC 0 group patients was younger than that of other groups and the AAC 3 group patients was older than the AAC grade 1 and AAC 2 grade patients.We did not find any differences in elevation,body weight,and BMI between AAC groups.5.AAC was positively correlated with(r=0.6,P<0.001),urea nitrogen(r=0.37,P<0.005),serum creatinine(r=0.42,P<0.001),LDL(r=0.27,P<0.05),and negatively with hemoglobin(r=-0.34,P<0.01),platelets(r=-0.27,P<0.05)and glomerular filtration rate(r=-0.53,P<0.001).Age is a risk factor for AAC and glomerular filtration rate is a protective factor for AAC.Conclusion:1.The AAC in patients with CKD3-5 stage aggravated with the increase of CKD stage,and aggravated with decreased renal function.2.Calcium and phosphorus metabolism disorders,dyslipidemia and elevated fastingblood glucose increase the severity of AAC in CKD patients.Age and the decline of glomerular filtration rate are independent risk factors for AAC.3.We may delay the development of calcification of abdominal aorta in patients with measures such as treating diabetes and hypertension,smoking cessation,protection of renal function,lipid lowering,and correction of calcium and phosphorus disorders in patients with CKD.