高剂量血液透析和血液透析滤过参数及其与晚期血管钙化的关系。
High dose haemodialysis and haemodiafiltration parameters and the relationship with advanced vascular calcification.
作者信息
Park Sung Keun, Kim Won Joong, Kim Hyun Jin, Kim Hae Won, Kim Beom, Lee Hong Joo, Lee So-Young, Lee Yu Ho, Kim Dong-Jin, Jeong Kyung-Hwan, Moon Ju-Young, Lee Sang-Ho, Ahn Shin Young, Ko Gang Jee, Ryoo Jae-Hong, Lee Dong-Young
机构信息
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Hansol hospital, Seoul, Republic of Korea.
出版信息
BMC Nephrol. 2020 Mar 6;21(1):86. doi: 10.1186/s12882-020-01738-4.
BACKGROUND
Vascular calcification (VC) is a risk factor for cardiovascular disease in end-stage renal disease (ESRD) patients undergoing maintenance haemodialysis (MHD). However, evidence is still insufficient about the association between dialysis parameters and VC. Thus, this study was to evaluate association of dialysis parameters with VC.
METHODS
We enrolled 297 ESRD patients undergoing MHD at six distinct centers in Korea. Study participants were categorized into 3 groups by the scoring system of abdominal aortic calcification based on lateral lumbar radiography (no VC group: 0, mild VC group: 1-7 and advanced VC group: 8-24). We compared the features of dialysis parameters according to the severity of VC. Multivariate logistic regression analysis was used to calculate adjusted odd ratios (ORs) and 95% confidence interval (CI) for mild and advanced VC in each haemodialysis parameter (adjusted OR [95% CI]).
RESULTS
Pooled Kt/V (spKt/V), equilibrated Kt/V (eKt/V), standard Kt/V (stdKt/V) and the proportion of haemodiafiltration were increased along with the severity of VC. Multivariate regression analysis indicated that advanced VC was positively associated with spKt/V (5.27 [1.51-18.41]), eKt/V (6.16 [1.45-26.10]), stdKt/V (10.67 [1.74-65.52]) and haemodiafiltration (3.27 [1.74 to 6.16]).
CONCLUSION
High dose dialysis and haemodiafiltration were significantly associated with advanced VC.
背景
血管钙化（VC）是接受维持性血液透析（MHD）的终末期肾病（ESRD）患者发生心血管疾病的危险因素。然而，关于透析参数与VC之间关联的证据仍不充分。因此，本研究旨在评估透析参数与VC的关联。
方法
我们纳入了韩国六个不同中心的297例接受MHD的ESRD患者。根据基于腰椎侧位X线片的腹主动脉钙化评分系统，将研究参与者分为3组（无VC组：0分，轻度VC组：1 - 7分，重度VC组：8 - 24分）。我们根据VC的严重程度比较了透析参数的特征。采用多因素逻辑回归分析计算每个血液透析参数中轻度和重度VC的校正比值比（OR）和95%置信区间（CI）（校正OR [95% CI]）。
结果
合并Kt/V（spKt/V）、平衡Kt/V（eKt/V）、标准Kt/V（stdKt/V）和血液透析滤过比例随VC严重程度增加而升高。多因素回归分析表明，重度VC与spKt/V（5.27 [1.51 - 18.41]）、eKt/V（6.16 [1.45 - 26.10]）、stdKt/V（10.67 [1.74 - 65.52]）和血液透析滤过（3.27 [1.74至6.16]）呈正相关。
结论
高剂量透析和血液透析滤过与重度VC显著相关。
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