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对透析前慢性肾病患者和维持性血液透析患者腹主动脉钙化的评估。

Assessment of abdominal aortic calcification in predialysis chronic kidney disease and maintenance hemodialysis patients.

作者信息

Dhakshinamoorthy Jagadeswaran, Elumalai Ram Prasad, Dev Bhawana, Hemamalini A J, Venkata Sai P M, Periasamy Soundararajan

机构信息

Department of Nephrology, Sri Ramachandra University, Chennai, Tamil Nadu, India.

Department of Radiology, Sri Ramachandra University, Chennai, Tamil Nadu, India.

出版信息

Saudi J Kidney Dis Transpl. 2017 Nov-Dec;28(6):1338-1348. doi: 10.4103/1319-2442.220855.

Abstract

Vascular calcification is associated with increased morbidity and mortality among chronic kidney disease (CKD) patients. The aim of the study was to assess the abdominal aortic calcification (AAC) in predialysis CKD patients and patients on hemodialysis (HD) and to study the risk factors associated with it. In this prospective study, 205 patients were including 104 patients with predialysis CKD and 101 patients were on maintenance hemodialysis. AAC was assessed using lateral lumbar radiography. Blood urea nitrogen, serum creatinine, albumin, calcium, phosphorus, highly sensitive C-reactive protein (hsCRP) and total cholesterol were analyzed. AAC was observed in 26 % of predialysis CKD patients and 34% in HD patients. Using multivariate analysis, the age (P = 0.001) was identified as independent predictor for the presence of AAC in predialysis patients, and for HD, the predictors were age (P = 0.025), time on dialysis (P = 0.001), hsCRP (P = 0.002), and corrected calcium (P = 0.030). In conclusion, the prevalence of AAC varies mainly with age and glomerular filtration rate levels in predialysis CKD patients. Advanced age, time on dialysis, and inflammation may be associated with presence and extent of AAC in HD patients. Further research into the risk factors and outcome for AAC is warranted.

摘要

血管钙化与慢性肾脏病(CKD)患者的发病率和死亡率增加相关。本研究的目的是评估透析前CKD患者和血液透析(HD)患者的腹主动脉钙化(AAC)情况,并研究与之相关的危险因素。在这项前瞻性研究中,纳入了205例患者,其中104例为透析前CKD患者,101例为维持性血液透析患者。采用腰椎侧位X线片评估AAC。分析血尿素氮、血清肌酐、白蛋白、钙、磷、高敏C反应蛋白(hsCRP)和总胆固醇。透析前CKD患者中26%观察到AAC,HD患者中为34%。通过多因素分析,年龄(P = 0.001)被确定为透析前患者存在AAC的独立预测因素,对于HD患者,预测因素为年龄(P = 0.025)、透析时间(P = 0.001)、hsCRP(P = 0.002)和校正钙(P = 0.030)。总之,透析前CKD患者中AAC的患病率主要随年龄和肾小球滤过率水平而变化。高龄、透析时间和炎症可能与HD患者AAC的存在和程度相关。有必要对AAC的危险因素和结局进行进一步研究。

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