Study On Related Factors Of Cardiovascular Calcification In Maintenance Peritoneal Dialysis Patients

Objective:To analyze the occurrence of cardiovascular calcification in patients with continuous ambulatory peritoneal dialysis(CAPD),and to explore risk factors of cardiovascular calcification.Methods:100 patients with continuous ambulatory peritoneal dialysis(CAPD)in the Second Affiliated Hospital of Kunming Medical University from September 2016 to June 2018 were enrolled into this study,who’s the relevant laboratory examinations and anthropometric indicators were collected.Cardiac valvular calcification(CVC)was determined by echocardiography,abdominal aortic calcification(AAC)wasdetermined by lateral abdominal radiographs,and the modified quantitative subjective global assessment(MQSGA)was used to assess the nutritional status of the patients.Patients were divided into three groups according to the score:normal nutrition,mild-to-moderate malnutrition,and severe malnutrition.Results:The prevalence of malnutrition was 68%in 100 patients,including 50%for mild to moderate group and 18%for severe group.In all patients,the prevalence of cardiovascular calcification was 55%,the prevalence of CVC was 46%,the prevalence of the AAC was 25%.The nutritional status showed significant differences among CVC,AAC,and cardiovascular calcification groups(xz=6.804,P 0.033;X2=11.870,P=0.003;X2=7.657,P=0.022).Nutritional status is positively correlated with inflammatory markers,and interleukin 6 was positively associated with nutritional status(P<0.05).Univariate analysis showed that the two groups of patients with or without cardiovascular calcification showed significant differences in age,dialysis age,serum albumin,serum pre-albumin,serum calcium,serum phosphorus,hypersensitive C-reactive protein,intact parathyroid hormone,interleukin 6 and calcium-phosphorus products(P<0.05).Multivariate logistic regression analysis showed that age(OR=1.064,P=0.009),serum pre-albumin(OR=0.985,P=0.014),serum phosphorus(OR=9.222,P=0.027)were independently associated with CVC.Age(OR=1.802,P=0.013),dialysis age(OR=1.047,P=001),and interleukin 6(OR=1.302,P=0.015)were independently associated with AAC.Age(OR=1.098,P=013),serum pre-albumin(OR=0.96,P=0.004),serum phosphorus(OR=9.653,P=0.042)were independently related to cardiovascular calcification.Conclusions:1.The nutritional status was related to micro-inflammation,the more severe the malnutrition,the higher the inflammation index in patients with CAPD.2.The prevalence of cardiovascular calcification was high in patients with CAPD,malnutrition is the risk factor of cardiovascular calcification,and the more malnourished,the higher the incidence of cardiovascular calcification.3.Age,dialysis age,serum albumin,serum pre-albumin,serum calcium,serum phosphorus,parathyroid hormone,calcium-phosphorus products,hypersensitive C-reactive protein,interleukin 6,high-density lipoprotein cholesterol are the influencing factors of cardiovascular calcification.4.Advanced age,low serum pre-albumin and high serum phosphorus are independent risk factors for CVC.5.Advanced age,Long dialysis age and interleukin-6 are independent risk factors for AAC.6.Advanced age,low serum pre-albumin and high serum phosphorus are independent risk factors for cardiovascular calcification.