Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong.
Singapore Med J. 2023 Jun;64(6):379-384. doi: 10.11622/smedj.2022052.
An echocardiographic calcium score (ECS) predicts cardiovascular disease (CVD) in the general population. Its utility in peritoneal dialysis (PD) patients is unknown.
This cross-sectional study assessed 125 patients on PD. The ECS (range 0-8) was compared between subjects with CVD and those without.
Among the subjects, 54 had CVD and 71 did not. Subjects with CVD were older (69 years vs. 56 years, P < 0.001) and had a higher prevalence of diabetes mellitus (DM) (81.5% vs. 45.1%, P < 0.001). They had lower diastolic blood pressure (72 mmHg vs. 81 mmHg, P < 0.001), lower phosphate (1.6 mmol/L vs. 1.9 mmol/L, P = 0.002), albumin (30 g/L vs. 32 g/L, P = 0.001), parathyroid hormone (34.4 pmol/L vs. 55.8 pmol/L, P = 0.002), total cholesterol (4.5 vs. 4.9, P = 0.047), LDL cholesterol (2.4 mmol/L vs. 2.8 mmol/L, P = 0.019) and HDL cholesterol (0.8 mmol/L vs. 1.1 mmol/L, P = 0.002). The ECS was found to be higher in subjects with CVD than in those without (2 vs. 1, P = 0.001). On multivariate analysis, only DM and age were independently associated with CVD.
The ECS was significantly higher in PD patients with CVD than in those without, reflecting a higher vascular calcification burden in the former. It is a potentially useful tool to quantify vascular calcification in PD patients.
超声心动图钙评分(ECS)可预测普通人群的心血管疾病(CVD)。其在腹膜透析(PD)患者中的应用尚不清楚。
本横断面研究评估了 125 名 PD 患者。比较了 CVD 患者和非 CVD 患者的 ECS(范围 0-8)。
在研究对象中,54 人患有 CVD,71 人没有。患有 CVD 的患者年龄较大(69 岁 vs. 56 岁,P < 0.001),且糖尿病(DM)患病率较高(81.5% vs. 45.1%,P < 0.001)。他们的舒张压(72 mmHg vs. 81 mmHg,P < 0.001)、血磷(1.6 mmol/L vs. 1.9 mmol/L,P = 0.002)、白蛋白(30 g/L vs. 32 g/L,P = 0.001)、甲状旁腺激素(34.4 pmol/L vs. 55.8 pmol/L,P = 0.002)、总胆固醇(4.5 vs. 4.9,P = 0.047)、低密度脂蛋白胆固醇(2.4 mmol/L vs. 2.8 mmol/L,P = 0.019)和高密度脂蛋白胆固醇(0.8 mmol/L vs. 1.1 mmol/L,P = 0.002)均较低。患有 CVD 的患者的 ECS 高于没有 CVD 的患者(2 分 vs. 1 分,P = 0.001)。多变量分析显示,只有 DM 和年龄与 CVD 独立相关。
与没有 CVD 的患者相比,PD 合并 CVD 的患者的 ECS 明显更高,反映了前者的血管钙化负担更高。它是一种定量评估 PD 患者血管钙化的潜在有用工具。