Correlation Between Serum Uric Acid And Arterial Calcification In Patients With Maintenance Hemodialysis

OBJECTIVE: To study the prevalence of hyperuricemia and arterial calcification in patients with maintenance hemodialysis(MHD)in our dialysis center,to understand the risk factors of arterial calcification in MHD patients and the correlation between serum uric acid and arterial calcification,in order to let clinical staff pay more attention to the prevention and treatment of hyperuricemia and arterial calcification.METHODS: The patients who underwent regular hemodialysis in A hospital in Qingdao from February 2015 to March 2018 were selected as subjects,and statistical analysis was made according to the inclusion and exclusion criteria.Using the most advanced X-ray imaging instrument in China to observe the degree of calcification of the celiac artery,and to detect the content of hormones in the blood such as SUA,BUN,SCr and blood calcium.The subjects were divided into two groups according to the uric acid value: high uric acid group(91 cases)and non-hyperuric acid group(50 cases).Patients with arterial calcification were divided into four groups according to the uric acid value: non-calcification group(68 cases),mild calcification group(14 cases),moderate calcification group(40 cases)and severe calcification group(19 cases),for the purpose of establishing database for statistics.The SPSS 19.0 statistical software was used to analyze the differences between patients' general clinical data,laboratory test results,and arterial calcification scores;the risk factors affecting arterial calcification levels and the relationship between blood uric acid and arterial calcification.RESULTS:(1)There were 141 patients who met the enrollment criteria,including 93 males(66%)and 91(64.54%)with hyperuricemia.The average age of these patients was(56.13±13.06)years old,and their average dialysis age(5.67±2.53)years;(2)MHD patients were grouped according to uric acid levels are as below: age,gender,drinking,smoking,high blood pressure,diabetes,taking calcium carbonate and KT/V as well as laboratory tests: there was no statistically significant difference(p>0.05)in blood calcium,blood phosphorus,hemoglobin,blood albumin,i PTH,triglyceride and total cholesterol.While the individual aspects of dialysis age,BMI,and physical indicators of difference among C-reactive protein,urea nitrogen and serum creatinine was statistically significant(p<0.05).The evaluation of calcification performance showed that patients with hyperuricemia were significantly higher than those without hyperuricemia.The results showed that the number of hospitalized patients with hyperuricemia due to cardiovascular disease(CVD)events was significantly higher than that of the normal group(p < 0.05),but there was no significant difference between the two groups in the death of cardiovascular diseases,respiratory diseases,systemic failure and infection(p > 0.05)(3)Among the 141 patients with MHD,68 were non-calcified,accounting for 48.2%,and 73 patients were with vascular calcification,accounting for 51.8% of MHD patients,including 14 patients with mild vascular calcification,accounting for 19.2% of calcification.There were 40 cases of moderate vascular calcification,accounting for 54.8%,and the number of severe vascular calcification was as high as 19 cases,accounting for 26% of the total patients.The comparison between groups showed that the individual differences in age,gender,daily life drinking,smoking,and basic physical indicators of blood calcium,blood phosphorus,hemoglobin,blood albumin,past medical history of triglyceride with KT/V has no statistically significant difference(p>0.05).There were statistically significant differences in dialysis age,smoking,blood phosphorus,i PTH,urea nitrogen,blood creatinine,blood uric acid and c-reactive protein(p<0.05)).(4)Univariate logistic regression analysis of MHD patients in this study showed that risk factors associated with arterial calcification included smoking,blood urea nitrogen and hyperuricemia(p<0.05)).Reincorporated the above significant variables into the logistic regression model and we can have the results suggest that hyperuricemia is still an important risk factor for arterial calcification in patients with MHD after exclusion of other multiple interfering factors(OR=1.031,95% CI=1.020~1.042,p<0.001).(5)Correlation analysis showed that there was a significant positive correlation between serum uric acid level and arterial calcification score in MHD patients(r = 0.889,p < 0.001).Conclusion: 1.The prevalence of hyperuricemia was significantly higher in MHD patients,and the calcification score was significantly higher in the hyperuricemia group than in the non-hyperuricemia group;2.The number of hospitalized patients with hyperuricemia in CVD events was significantly higher than that in the normal blood uric acid group(p <0.05).3.More than half of the MHD patients had arterial calcification,and the arterial calcification score has a positive correlation with blood uric acid level.There was a significant;4.Possible factors related to arterial calcification were hyperuricemia,high urea nitrogen,and smoking.This study suggests that hyperuricemia is an independent risk factor for arterial calcification in patients with MHD.