Analysis Of Risk Factors Related To Cardiac Valve Calcification In Continuous Ambulatory Peritoneal Dialysis Patients

Background:Continuous ambulatory peritoneal dialysis(CAPD)is one of the renal replacement therapies in patients with end-stage renal disease(ESRD).With the continuous improvement of Peritoneal dialysis(PD)products and technologies,the quality of life,social regression rate and long-term survival rate of CAPD patients have been improved significantly.However,the incidence of cardiovascular disease in CAPD patients is still relatively high,which seriously affects its prognosis.Cardiac valve calcification(CVC)is closely related to cardiovascular complications,which is of great value in predicting the occurrence of cardiovascular events and an independent risk factoring for cardiovascular events,cardiovascular death and all-cause death in ESRD patients.Therefore,it is of great significance to study the risk factors related to cardiac valve calcification and take early intervention measures to reduce cardiovascular disease and mortality in CAPD patients.Objective:To study the related risk factors of cardiac valve calcification in CAPD patients,provide a basis for prevention and treatment of cardiac valve calcification and reduction of cardiovascular disease.Methods:112 CAPD patients who had been on stable dialysis for more than 6 months were selected from the peritoneal dialysis center of the first hospital of Jilin University during January 2017 to June 2018.According to whether the occurrence of cardiac valve calcification,patients were divided into CVC group and non-CVC group.General clinical data,dialysis-related indicators,laboratory index,echocardiography data,whether there were myocardial ischemia and other data of these patients were collected.Analysis whether the clinical data and test indexes between CVC group and non-CVC group have statistical significance.Using IBM SPSS 20.0 software for statistical description and analysis of the above data.The normal or approximate normal distribution of measurement data were expressed in((?)±s),the skewed distribution of measurement data were represented by the M(P25,P75);independent samples T test was used to compare the two groups of normally distributed data,and Mann-Whitney U test was used in skewed distribution data;the counting data were represented by frequency(composition ratio),and chi-square test was used for comparison between groups;multi-factor logistic regression analysis was used to analyze the independent influencing factors of cardiac valve calcification.P<0.05 was considered statistically significant.Results:1.112 CAPD patients were selected for this study,including 37 patients in the CVC group and 75 patients in the non-CVC group.The incidence of CVC was 33.0%.In the CVC group,24 patients had aortic valve calcification merely(64.9%),3 patients had mitral valve calcification merely(8.1%),and 10 patients had aortic valve calcification combined with mitral valve calcification(27.0%).2.Compared with patients in the non-CVC group,patients in the CVC group were older,and had a larger left atrial diameter,higher blood phosphorus,higher calcium-phosphorus product,higher blood glucose,lower prealbumin,and the difference was statistically significant(P<0.05).Patients with diabetes mellitus had a higher incidence of cardiac valve calcification(P<0.01).There was no statistically significant difference in blood pressure,serum calcium,parathyroid hormone,creatinine and other indicators between the two groups(P>0.05).3.After using Logistic regression analysis(forward method),age,the calcium-phosphorus product and left atrial diameter were positively correlated with cardiac valve calcification independently in CAPD patients(P<0.01).4.Furthermore,Univariate analysis was performed using aortic valve calcification and mitral valve calcification as dependent variables in CAPD patients,and variables with P<0.05 in univariate analysis were regard as covariates.Logistic regression analysis(forward method)showed that age,left atrial diameter,diabetes mellitus,and the calcium-phosphorus product were positively correlated with aortic valve calcification independently(P<0.05);Age,the calcium-phosphorus product were positively correlated with mitral valve calcification independently(P<0.05),while low density lipoprotein was negatively correlated with mitral valve calcification independently(P<0.05).5.The proportion of patients with myocardial ischemia in the CVC group was 75.7%,significantly higher than that in the non-CVC group 41.3%,and there were significant differences between the two groups(P<0.01).Conclusions:1.Cardiac valve calcification in patients with CAPD is most common in the aortic valve and mitral valve.2.In CAPD patients,the proportion of cardiac valve calcification is increased with age,blood phosphorus,the calcium-phosphorus product,blood glucose,left atrial diameter increased and prealbumin decreased.3.Age,the calcium-phosphorus product,left atrial diameter and diabetes mellitus are independent risk factors for aortic valve calcification;while age,the calcium-phosphorus product and lower levels of low density lipoprotein are independent risk factors for mitral valve calcification in CAPD patients.