Medical Research Unit in Renal Diseases, Specialty Hospital, CMNO, IMSS, Guadalajara, Mexico.
Arch Med Res. 2013 Nov;44(8):628-32. doi: 10.1016/j.arcmed.2013.10.018. Epub 2013 Nov 8.
Vascular calcification (VC) is a predictor of poor survival and cardiovascular outcome in end-stage renal disease (ESRD) patients; however, there is scarce information of VC in Latin America, and virtually no data in our setting. We undertook this study to evaluate the prevalence and characteristics of VC in a hemodialysis (HD) population from western Mexico and to determine possible associated factors.
This was a cross-sectional study performed in 52 patients. VC was evaluated using plain X-ray films (Adragao's score) of hands and pelvis; clinical and biochemical variables were also collected. Statistical analysis was carried out with Student t and χ(2) tests performed as appropriate and logistic regression to determine predictors of VC.
Mean age was 43 years, 48% were female, 23% had diabetes mellitus (DM), and median time on dialysis was 46 months. Percentage prevalence was 52% with a mean calcification score of 2.0 ± 2.6; 23% of patients had severe calcification. VC was present in about 23-37% among the different vascular territories evaluated (radial, digital, femoral and iliac). Patients with calcification were significantly older, had a higher frequency of DM, higher alkaline phosphatase and lower HDL lipoproteins than those without VC. In the multivariate analysis, VC in these patients was significantly predicted only by an older age (OR [95% CI]: 1.15 [1.01-1.31], p = 0.04); lower HDL-cholesterol and higher alkaline phosphatase were marginal predictors.
Half of our HD patients had VC. Territories of radial, iliac, femoral and digital arteries were roughly equally affected, and 25% of patients had a calcification considered as severe. Older age was the only significant predicting variable for VC, with low HDL-cholesterol and high alkaline phosphatase as marginal predictors.
血管钙化（VC）是终末期肾病（ESRD）患者生存和心血管预后不良的预测因素；然而，拉丁美洲关于 VC 的信息很少，我们的研究中几乎没有数据。我们进行这项研究是为了评估来自墨西哥西部血液透析（HD）人群中 VC 的患病率和特征，并确定可能的相关因素。
这是一项横断面研究，共纳入了 52 名患者。使用手部和骨盆的普通 X 射线片（Adragao 评分）评估 VC；还收集了临床和生化变量。使用学生 t 检验和 χ²检验进行适当的统计分析，并进行逻辑回归以确定 VC 的预测因素。
平均年龄为 43 岁，48%为女性，23%患有糖尿病（DM），透析时间中位数为 46 个月。患病率为 52%，平均钙化评分 2.0±2.6；23%的患者存在严重钙化。在评估的不同血管区域（桡动脉、指动脉、股动脉和髂动脉）中，VC 的存在率约为 23%-37%。存在钙化的患者明显比无 VC 的患者年龄更大，DM 发生率更高，碱性磷酸酶更高，高密度脂蛋白胆固醇（HDL 脂蛋白）更低。在多变量分析中，仅年龄较大（OR[95%CI]：1.15[1.01-1.31]，p=0.04）可显著预测这些患者的 VC；低 HDL-胆固醇和高碱性磷酸酶是边缘预测因素。
我们的一半 HD 患者存在 VC。桡动脉、髂动脉、股动脉和指动脉的受累程度大致相同，25%的患者存在被认为是严重的钙化。年龄较大是 VC 的唯一显著预测变量，低 HDL-胆固醇和高碱性磷酸酶是边缘预测因素。
