Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Hospital, Chongqing University, Chongqing, China.
Ren Fail. 2022 Dec;44(1):224-232. doi: 10.1080/0886022X.2022.2032742.
Cardiac valve calcification (CVC) is an important risk factor for cardiovascular complications. However, limited data are available concerning the prevalence, clinical features and risk factors for CVC in end-stage kidney disease (ESKD) patients. In this study, we aimed to assess these parameters in Chinese ESKD patients receiving combination therapy with hemodialysis and hemodiafiltration.
We conducted a cross-sectional study on 293 ESKD patients undergoing combination therapy of hemodialysis and hemodiafiltration at the First Affiliated Hospital of Chongqing Medical University from October 2014 to December 2015. CVC was evaluated echocardiography.
ESKD patients with CVC had a higher prevalence of diabetes mellitus, aortic and/or coronary artery calcification, arrhythmia, heart failure and coronary heart disease; increased systolic, diastolic and pulse pressure; longer duration of hemodialysis and hypertension; reduced hemoglobin, albumin and high-density lipoprotein cholesterol levels; and increased serum calcium and calcium-phosphorus product levels compared with those without CVC. Logistic regression analysis showed that increased dialysis duration ( = 0.006, OR = 2.25), serum calcium levels ( = 0.046, OR = 2.04) and pulse pressure ( < 0.001, OR = 3.22), the presence of diabetes ( = 0.037, OR = 1.81) and decreased serum albumin levels ( = 0.047, OR = 0.54) were risk factors for CVC. The correlation analysis indicated a significantly increased CVCs prevalence with an increase prevalence of heart failure, aortic and coronary artery calcification.
CVC represents a common complication and a danger signal for cardiovascular events in ESKD patients undergoing combination therapy of hemodialysis and hemodiafiltration. The presence of diabetes, increased pulse pressure, long dialysis duration, hypoalbuminemia and high serum calcium levels were independent risk factors for CVC.
心脏瓣膜钙化（CVC）是心血管并发症的一个重要危险因素。然而，关于终末期肾病（ESKD）患者 CVC 的患病率、临床特征和危险因素的数据有限。在本研究中，我们旨在评估在重庆医科大学第一附属医院接受血液透析和血液透析滤过联合治疗的中国 ESKD 患者的这些参数。
我们对 2014 年 10 月至 2015 年 12 月在重庆医科大学第一附属医院接受血液透析和血液透析滤过联合治疗的 293 例 ESKD 患者进行了横断面研究。通过超声心动图评估 CVC。
患有 CVC 的 ESKD 患者中糖尿病、主动脉和/或冠状动脉钙化、心律失常、心力衰竭和冠心病的患病率较高；收缩压、舒张压和脉压较高；血液透析时间较长且高血压的比例较高；血红蛋白、白蛋白和高密度脂蛋白胆固醇水平较低；血清钙和钙磷乘积水平较高。Logistic 回归分析显示，透析时间延长（=0.006，OR=2.25）、血清钙水平升高（=0.046，OR=2.04）和脉压升高（<0.001，OR=3.22）、糖尿病的存在（=0.037，OR=1.81）和血清白蛋白水平降低（=0.047，OR=0.54）是 CVC 的危险因素。相关性分析表明，心力衰竭、主动脉和冠状动脉钙化的患病率增加与 CVC 的患病率呈显著正相关。
CVC 是接受血液透析和血液透析滤过联合治疗的 ESKD 患者心血管事件的常见并发症和危险信号。糖尿病的存在、脉压升高、透析时间延长、低白蛋白血症和高血清钙水平是 CVC 的独立危险因素。
