Department of Nephrology, University Federico II of Naples, Naples, Italy.
Blood Purif. 2013;36(1):17-20. doi: 10.1159/000350580. Epub 2013 May 25.
BACKGROUND/AIMS: Presence and progression of coronary artery calcification (CAC) indicate severe atherosclerosis and predict cardiovascular events (CVE) in dialysis (ESRD patients) and nondialysis patients (CKD patients). This study aimed at evaluating the prevalence and progression of CAC and CVE in CKD patients with diabetes in whom atherosclerosis of coronary arteries is the leading cause of CVE.
This was a retrospective study conducted in both out- and in-patients with chronic kidney disease, stage 2-5. CAC were assessed by the total calcium (TC) score. CT scans were performed at the entry and at the end of the study.
Patients (n = 341) were divided into nondiabetic (n = 281) and diabetic patients (n = 60). CAC prevalence and TC score were higher in diabetics and associated with age, diabetes mellitus and pulse pressure. Diabetics with CKD presented a higher percentage of CAC progression and CVE.
Prevalence, extent, progression of CAC and CVE are higher in diabetics with concomitant CKD. These findings may promote a more aggressive protocol of screening and care in type 2 diabetics with concomitant CKD.
背景/目的：冠状动脉钙化（CAC）的存在和进展表明存在严重的动脉粥样硬化，并可预测透析（ESRD 患者）和非透析患者（CKD 患者）的心血管事件（CVE）。本研究旨在评估糖尿病合并 CKD 患者 CAC 和 CVE 的发生率和进展情况，在这些患者中，冠状动脉粥样硬化是 CVE 的主要原因。
这是一项在门诊和住院慢性肾脏病 2-5 期患者中进行的回顾性研究。CAC 通过总钙（TC）评分进行评估。在研究开始和结束时进行 CT 扫描。
患者（n=341）分为非糖尿病组（n=281）和糖尿病组（n=60）。糖尿病患者 CAC 的患病率和 TC 评分更高，且与年龄、糖尿病和脉压相关。合并 CKD 的糖尿病患者 CAC 进展和 CVE 的比例更高。
同时患有 CKD 的糖尿病患者 CAC、TC 评分、CVE 的患病率、严重程度和进展程度更高。这些发现可能会促进对合并 CKD 的 2 型糖尿病患者进行更积极的筛查和治疗方案。
