Krzanowski Marcin, Kuśnierz-Cabala Beata, Miarka Przemysław, Wójcik Katarzyna, Stompór Tomasz, Sułowicz Wladyslaw
Department of Nephrology, Jagiellonian University, Collegium Medicum, Cracow, Poland.
Med Pregl. 2007;60 Suppl 2:39-42.
Calcium-phosphate disorders and vascular calcification are highly prevalent in patients with diabetes mellitus and nephropathy. The aim of the study was to compare the prevalence and advancement of vascular calcification in patients with end-stage diabetic nephropathy on peritoneal dialysis and diabetic patients with chronic renal disease stages 2-4. The study group included 31 patients with type 2 diabetes and diabetic nephropathy divided into 2 groups: 12 patients (aged 50-74 years: mean 58.6+/-8.8) undergoing peritoneal dialysis and 19 patients (aged 46-82 years; mean 65.8+/-9.7) with chronic kidney disease stages 2-4 (GFR range 24-78 ml/min/1.73 m2). Coronary artery calcification score, was assessed using multi-slice computed tomography. Coronary artery calcification score did not differ significantly between groups (CaSc values 1085.2 vs 452.4 AgU; NS). The patients undergoing peritoneal dialysis showed significantly higher levels of parathyroid hormone (658.2 vs. 74.3 pg/ml; p=0.001), fibrinogen (5.82 vs. 3.89 g/l; p<0.0001) and alkaline phosphatase (330.9 vs. 168.0 U/l; p=0.001). Despite more advanced abnormalities in calcium-phosphate balance parameters and more active inflammation in peritoneal dialysis subjects we failed to demonstrate any statistically significant difference in coronary artery calcification score between patients with diabetic nephropathy on peritoneal dialysis and those with chronic kidney disease stages 2-4.
钙磷紊乱和血管钙化在糖尿病和肾病患者中极为普遍。本研究的目的是比较终末期糖尿病肾病腹膜透析患者与慢性肾病2 - 4期糖尿病患者血管钙化的患病率和进展情况。研究组包括31例2型糖尿病和糖尿病肾病患者，分为2组：12例（年龄50 - 74岁，平均58.6±8.8岁）接受腹膜透析，19例（年龄46 - 82岁，平均65.8±9.7岁）患有慢性肾病2 - 4期（肾小球滤过率范围24 - 78 ml/min/1.73 m²）。使用多层计算机断层扫描评估冠状动脉钙化评分。两组之间冠状动脉钙化评分无显著差异（钙化评分值分别为1085.2和452.4 AgU；无统计学意义）。接受腹膜透析的患者甲状旁腺激素水平显著更高（分别为658.2和74.3 pg/ml；p = 0.001）、纤维蛋白原水平（分别为5.82和3.89 g/l；p < 0.0001）和碱性磷酸酶水平（分别为330.9和168.0 U/l；p = 0.001）。尽管腹膜透析患者的钙磷平衡参数异常更严重且炎症更活跃，但我们未能证明腹膜透析的糖尿病肾病患者与慢性肾病2 - 4期患者之间冠状动脉钙化评分存在任何统计学上的显著差异。
