Division of Nephrology, Department of Radiology and Cardiology, School of Medicine, Ege University, Izmir, Turkey.
Nephrol Dial Transplant. 2011 Mar;26(3):1010-5. doi: 10.1093/ndt/gfq491. Epub 2010 Aug 13.
Vascular calcifications are frequent in Stage 5 chronic kidney disease (CKD-5) patients receiving haemodialysis. The current study was designed to evaluate the associations between bone turnover/volume and coronary artery calcifications (CAC).
In 207 CKD-5 patients, bone biopsies, multislice computed tomography of the coronary arteries and blood drawings for relevant biochemical parameters were done. The large number of CKD-5 patients enrolled allowed separate evaluation of patients with CAC versus patients without CAC and adjustment for traditional and non-traditional risk factors for CAC.
When all patients were analysed, associations were found between CAC and bone turnover, bone volume, age, gender and dialysis vintage. When only patients with CAC were included, there was a U-shaped relationship between CAC and bone turnover, whilst the association with bone volume was lost. In these patients, the relationship of CAC with age, gender and dialysis vintage remained.
Beyond the non-modifiable risk factors of age, gender and dialysis vintage, these data show that bone abnormalities of renal osteodystrophy amenable to treatment should be considered in the management of patients with CAC.
在接受血液透析的 5 期慢性肾脏病（CKD-5）患者中，血管钙化很常见。本研究旨在评估骨转换/体积与冠状动脉钙化（CAC）之间的关系。
在 207 例 CKD-5 患者中，进行了骨活检、冠状动脉多层计算机断层扫描和相关生化参数的血液采集。由于纳入了大量的 CKD-5 患者，因此可以分别评估有 CAC 的患者和无 CAC 的患者，并对 CAC 的传统和非传统危险因素进行调整。
当分析所有患者时，发现 CAC 与骨转换、骨量、年龄、性别和透析龄有关。当仅纳入有 CAC 的患者时，CAC 与骨转换之间呈 U 形关系，而与骨量的关系则消失。在这些患者中，CAC 与年龄、性别和透析龄的关系仍然存在。
除了年龄、性别和透析龄等不可改变的危险因素外，这些数据表明，应在 CAC 患者的管理中考虑可治疗的肾性骨营养不良的骨骼异常。
