Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, PR China.
J Nephrol. 2012 Mar-Apr;25(2):219-24. doi: 10.5301/JN.2011.8478.
Patients with chronic kidney disease (CKD) are more likely to have complications due to cardiovascular disease (CVD). This study was performed to investigate the prevalence of chronic kidney disease (CKD) and the relation of CKD and number of stenosed coronary vessels in patients who had undergone coronary angiography with suspected coronary artery disease (CAD).
The data of 1,010 consecutive patients who underwent coronary angiography for suspected CAD in Zhongda Hospital were analyzed. Estimated glomerular filtration rate (eGFR) was calculated with the abbreviated Modified Diet in Renal Disease (MDRD) Study equation. CKD was defined as presence of eGFR <60 ml/min per 1.73 m(2) and/or proteinuria. Luminal narrowing with at least 1 lesion =50% in the main branches of the coronary artery was considered as CAD. The number of stenotic arteries was recorded (1- to 3-vessel disease [VD]). A significant stenosis in the left main trunk was scored as 2-VD.
Patients with CAD had a significantly higher prevalence of CKD compared with patients without CAD (18.8% vs. 5.4%, p<0.001). CKD was significantly associated with CAD, 2-VD and 3-VD, versus without CAD (0-VD) (odds ratio [OR] = 2.163; 95% confidence interval [95% CI], 1.296-3.611; OR=2.478; 95% CI, 1.288-4.766; OR=2.504; 95% CI, 1.271-4.933; respectively) after adjustment for covariates.
There was a higher prevalence of CKD in patients with CAD diagnosed by coronary angiography, and it increased with the number of stenosed coronary vessels. CKD is a critical risk factor for CAD, especially 3-VD.
患有慢性肾脏病（CKD）的患者更容易因心血管疾病（CVD）而出现并发症。本研究旨在探讨经冠状动脉造影诊断为疑似冠心病（CAD）的患者中慢性肾脏病（CKD）的患病率以及 CKD 与狭窄冠状动脉血管数之间的关系。
分析了在中大医院因疑似 CAD 而行冠状动脉造影的 1010 例连续患者的数据。采用简化肾脏病膳食改良试验（MDRD）研究方程估算肾小球滤过率（eGFR）。CKD 的定义为 eGFR<60ml/min/1.73m2 和/或蛋白尿。主要冠状动脉分支至少有 1 处狭窄≥50%的狭窄被认为是 CAD。记录狭窄动脉数（1-3 支血管病变[VD]）。左主干狭窄程度显著者，计为 2-VD。
与无 CAD 患者相比，CAD 患者的 CKD 患病率显著更高（18.8% vs. 5.4%，p<0.001）。与无 CAD（0-VD）患者相比，CKD 与 CAD、2-VD 和 3-VD 显著相关（OR=2.163；95%可信区间[95%CI]，1.296-3.611；OR=2.478；95%CI，1.288-4.766；OR=2.504；95%CI，1.271-4.933；分别），校正了混杂因素后。
经冠状动脉造影诊断为 CAD 的患者中 CKD 的患病率更高，且随着狭窄冠状动脉血管数的增加而增加。CKD 是 CAD 的一个重要危险因素，特别是 3-VD。
