Correlation Between Cardiac Insufficiency And Clinical Indicators Such As Calcium And Phosphorus And The Distribution Of TCM Syndrome Types In CKD Patient

Purpose:To evaluate the cardiac function of patients with chronic kidney disease(CKD)and analyze the incidence of cardiorenal syndrome(CRS)in patients with CKD and its correlation with clinical indexes such as calcium and phosphorus,in order to reduce the risk of CRS in patients with CKD,explore the distribution of TCM syndrome types,provide reference for TCM syndrome differentiation and improve the prognosis of CKD patients.Material and method:1.The patients who met the CKD diagnosis in the Department of Nephrology of the affiliated Hospital of Liaoning University of traditional Chinese Medicine from September 2021 to December 2021 were selected and the data of those who met the inclusion criteria were collected.2.The patients were divided into groups according to the presence of cardiac insufficiency.The general data of the patients(name,age,sex,primary disease,etc.)and clinical indexes such as serum phosphorus,serum calcium,serum creatinine,blood urea nitrogen,serum uric acid,glomerular filtration rate,hemoglobin,serum albumin,triglyceride,cholesterol and blood pressure were recorded.Carry on TCM syndrome differentiation according to its four diagnosis information,and analyze its TCM syndrome type.3.Set up a database of the collected data and use SPSS25.0 statistical software for statistical analysis to explore the correlation between cardiac insufficiency and clinical indicators such as calcium and phosphorus in patients with CKD,and the distribution law of TCM syndrome types.Results:1.General analysis: among the 112 patients included in the study,there were 1 CKD2 patient(1%),17 CKD3 patients(15%),14 CKD4 patients(13%)and 80 CKD5 patients(71%).According to the existence of cardiac insufficiency,there were 71 cases(63%)in cardiac insufficiency group and 41 cases(37%)in non-cardiac insufficiency group.There was statistical significance between CKD stage and cardiac insufficiency(X2: 26.73,P = 0.000).After correction by artificial a-cut method,it was found that there was statistical significance between CKD5 stage and CKD3 stage and cardiac function state(X2 stage 25.61).Patients with CKD5 stage were more likely to develop cardiac insufficiency.However,the existence of cardiac insufficiency in patients with CKD had no statistical significance with age,sex,primary disease and other general conditions(P > 0.05).2.Clinical index analysis: the existence of cardiac insufficiency in patients with CKD was significantly correlated with serum phosphorus,serum calcium,serum creatinine,blood urea nitrogen,glomerular filtration rate,hemoglobin,but not with serum uric acid,serum albumin,triglyceride,cholesterol,urinary albumin and blood pressure(P > 0.05).3.A binary logistic regression model was constructed between the clinical indexes and the state of cardiac function,which were statistically different from the existence of cardiac insufficiency.After analysis,it was found that serum phosphorus,serum calcium,glomerular filtration rate were closely related to cardiac insufficiency(P < 0.05).3.A binary logistic regression model was constructed between the clinical indexes and the state of cardiac function,which were statistically different from the existence of cardiac insufficiency.After analysis,it was found that serum phosphorus,serum calcium,glomerular filtration rate were closely related to cardiac insufficiency(P < 0.05).4.Distribution law of syndrome types: 35 cases of yang deficiency syndrome,accounting for the highest proportion(31%),30 cases of qi deficiency syndrome,accounting for 27%,24 cases of yin deficiency syndrome(22%),17 cases of qi-yin deficiency syndrome(15%),6 cases of yin-yang deficiency syndrome(5%).Among the concurrent syndromes,damp-turbid syndrome accounted for the highest proportion in 38 cases(34%),followed by blood stasis syndrome in 17 cases(15%),phlegm drinking syndrome and no concurrent syndrome in 16 cases(14%),water-qi syndrome in 13 cases(12%),and damp-heat syndrome in 12 cases(11%).5.Relationship between syndrome type and cardiac function: in this syndrome,in the group of non-cardiac insufficiency,the syndrome of qi deficiency is the most,accounting for 41.5%.In the group of cardiac insufficiency,the number of yang deficiency syndrome is the most,accounting for 39.4%.Among the concurrent syndromes,the proportion of damp-turbid syndrome was the highest in the group without cardiac insufficiency(29.3%),followed by damp-heat syndrome(19.5%).The highest proportion in the group with cardiac insufficiency was damp-turbid syndrome(36.6%),followed by phlegm-drinking syndrome(22.5%).There were significant differences between the two groups and cardiac function(P < 0.05).Conclusion:1.In this study,the incidence of cardiac insufficiency in patients with CKD is about 63%.Patients with stage 5 CKD have a higher risk of this complication.2.The study shows that high phosphorus,low calcium and decreased glomerular filtration rate are independent risk factors of cardiac insufficiency in patients with CKD.Calcium and phosphorus indexes in patients with CKD should be monitored and intervention should be carried out.3.In this study,the syndrome of CKD is mainly qi deficiency in the early stage,yin deficiency syndrome gradually appears with the progress of the disease,and yang deficiency syndrome is the most in CKD5;for concurrent syndrome,CKD has no concurrent syndrome in the early stage and dampness-turbid syndrome in the late stage.Most of the patients with cardiac insufficiency were yang deficiency syndrome,and most of them were damp-turbid and phlegm-drinking syndrome.