Szarejko-Paradowska Anna, Gluba-Brzózka Anna, Pietruszyński Robert, Rysz Jacek
Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland.
Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland.
Int Urol Nephrol. 2015 Dec;47(12):2003-12. doi: 10.1007/s11255-015-1132-8. Epub 2015 Oct 22.
Renal diseases pose a growing epidemiological and health problem worldwide. Cardiovascular diseases are the leading cause of deaths among patients with chronic kidney disease. Increased risk of atherosclerosis in these patients results from the occurrence of traditional and non-traditional risk factors. The aim of this study was to assess the relationship between selected risk factors for cardiovascular diseases (age, sex, dyslipidemia, hypertension, etc.), intima-media thickness and coronary artery calcium score in patients with chronic kidney disease stages 2, 3 and 4. This study included 60 patients with chronic kidney disease divided into 3 groups on the basis of disease stage and control group consisting of 20 individuals without diagnosed chronic kidney disease and cardiovascular diseases. Blood analysis and blood pressure measurements were taken. All patients underwent carotid artery ultrasound with the assessment of the intima-media thickness, and heart CT scan in order to assess the index of coronary artery calcification. Logistic regression analysis revealed statistically significant correlation between blood vessels calcification and age--the increase in age by 1 year was associated with the increase in the risk of coronary artery calcification by 6.7 %. The increase in IMT by about 0.1 mm raises the risk of calcification by about 2 %. Second logistic regression model revealed that one-year increase in age was associated with an increase in the risk of intima-media thickening by 6.5 %. Occurrence of hypertension was associated with a ninefold increase in intima-media thickening risk in comparison with patients with normal blood pressure. To sum up, age and hypertension were associated with the growth of IMT in CKD patients, while age and exposure to tobacco smoke were associated with the increase in coronary artery calcium score. The relationship between thickening of IMT and the increase in calcification index in patients was also observed in study group.
肾脏疾病在全球范围内构成了日益严重的流行病学和健康问题。心血管疾病是慢性肾脏病患者死亡的主要原因。这些患者动脉粥样硬化风险增加是由传统和非传统风险因素的出现导致的。本研究的目的是评估慢性肾脏病2、3和4期患者中选定的心血管疾病风险因素（年龄、性别、血脂异常、高血压等）、内膜中层厚度和冠状动脉钙化评分之间的关系。本研究纳入了60例慢性肾脏病患者，根据疾病阶段分为3组，对照组由20例未诊断出慢性肾脏病和心血管疾病的个体组成。进行了血液分析和血压测量。所有患者均接受了颈动脉超声检查以评估内膜中层厚度，并进行了心脏CT扫描以评估冠状动脉钙化指数。逻辑回归分析显示血管钙化与年龄之间存在统计学上的显著相关性——年龄每增加1岁，冠状动脉钙化风险增加6.7%。内膜中层厚度增加约0.1mm会使钙化风险增加约2%。第二个逻辑回归模型显示，年龄每增加1岁，内膜中层增厚风险增加6.5%。与血压正常的患者相比，高血压的出现使内膜中层增厚风险增加了9倍。总之，年龄和高血压与慢性肾脏病患者内膜中层厚度增加有关，而年龄和接触烟草烟雾与冠状动脉钙化评分增加有关。在研究组中也观察到了患者内膜中层增厚与钙化指数增加之间的关系。
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