Investigation On The Related Factors Of Vascular Calcification In Newly Admitted Hemodialysis Patients

Objective: To investigate the status and clinical characteristics of vascular calcification in newly admitted hemodialysis patients,to find the related factors for vascular calcification in dialysis patients,and to provide theoretical basis for future basic research and intervention treatment on vascular calcification.Methods:A total of 91 newly admitted hemodialysis patients hospitalized in the Department of Nephrology of the Third Hospital of Hebei Medical University from November 2019 to December 2020 were included as the case group,and 20 healthy volunteers were recorded as the healthy control group during the same period.Clinical data indicators and calcification scores of abdominal aortic calcification and cardiac valve calcification were collected from all study subjects,blood specimens were retained,and the serum BMP-2and BMP7 were measured by enzyme-linked immunosorbent assay(ELISA),and SPSS 22.0 software was applied to statistical analysis to compare the clinical data and laboratory indicators of each group and analyze the risk factors affecting the incidence of vascular calcification.Results:1.This study included 91 newly admitted hemodialysis patients,including 47 males(51.6%)and 44 females(48.4%),with an average age of(58.07±13.03)years.Among 33 patients(36.26%)with vascular calcification,were grouped according to the abdominal aortic and cardiac valve of calcification:20 cases in the mild calcification group and 13 cases in the moderate-severe calcification group.2.The level of BMP2 increased with the increase of calcification,and was(48.24±8.88)pg/ml,(54.51±3.06)pg/ml,and(63.11±4.44)pg/ml in the non-calcification,mild-calcification,and moderate-severe calcification groups,respectively,with statistically significant among the groups(P<0.05).while the level of BMP7 decreased,with(45.94±6.01)pg/ml,(35.35±2.42)pg/ml and(28.62±4.37)pg/ml in the non-calcification,mild-calcification and moderate-severe calcification groups,with statistically significant differences(P<0.05).The age,phosphorus and calcium-phosphorus product were statistically significant when compared among the three groups,with the age,phosphorus and calcium-phosphorus product in the moderate to severe calcification group being higher than those in the other calcification groups(P<0.05).While hemoglobin,blood albumin,total cholesterol,triglyceride,phosphatase,parathyroid hormone,serum calcium were not different(P>0.05).3.The Spearman correlation analysis showed the score of vascular calcification was positively correlated with age(r=0.370,P=0.034),blood phosphorus(r=0.408,P=0.019),calcium-phosphorus product(r=0.419,P=0.013)and BMP2(r=0.791,P<0.001)and negatively correlated with BMP7(r=-0.617,P<0.001).4.Multivariate Logistic regression analysis of all the subjects showed that age,blood phosphorus,calcium-phosphorus product,and BMP2 were independent risk factors for vascular calcification in newly admitted hemodialysis patients(OR=19.279,95%CI=3.444-107.903,P=0.001;OR=1.191,95%CI=1.097-1.293,P<0.001);while serum BMP7(OR=0.595,95%CI=0.464-0.763,P<0.001)is a protective factor.Conclusions:1.Vascular calcification in newly admitted hemodialysis patients with incidence being 36.26%,which requires early attention.2.There are differences in the age,blood phosphorus,calcium and phosphorus product of patients with different calcification,and they are highly correlated with the levels of BMP2 and BMP7,suggesting that early active control of calcium-phosphorus metabolism disorders is of great significance for slowing the progress of calcification.3.In newly admitted hemodialysis patients,especially those with vascular calcification,the level of serum BMP2 increases and BMP7 decreases,which are closely related to calcium-phosphorus metabolism.And multivariate Logistic regression analysis shows high serum BMP2 expression and low serum BMP7 expression are important risk factors for vascular calcification,suggesting that both may be involved in the process of vascular calcification,but the specific mechanism needs further basic and prospective research.