Yao Dan-Dan, Yan Xiao-Wei, Zhou Yan, Li Zuo-Lin, Qiu Fang-Xin
Department of Nephrology, Chengyang District People's Hospital, Qingdao, China.
Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China.
Ren Fail. 2025 Dec;47(1):2456690. doi: 10.1080/0886022X.2025.2456690. Epub 2025 Jan 26.
Vascular calcification is common and progressive in patients with chronic kidney disease. However, the risk factors associated with the progression of vascular calcification in patients receiving maintenance dialysis have not been fully elucidated. Here, we aimed to evaluate vascular calcification and identify the factors associated with its progression in patients receiving maintenance hemodialysis.
This is a prospective longitudinal study that included 374 patients receiving maintenance hemodialysis. The participants received assessments of coronary artery calcification (CAC) and abdominal aortic calcification (AAC), as measured by computed tomography. After the baseline investigation, a 2 years follow-up was performed. We also detected the markers of endothelial injury [E-selectin and soluble intercellular adhesion molecule-1 (sICAM-1)]. Finally, the risk factors affecting the CAC and AAC progression were examined by multivariate logistic regression analysis.
Among 374 patients, the median [interquartile range (IQR)] age was 54.0 (40.0-62.0) years; 59.9% of patients were male. The median (IQR) follow-up time was 1.9 (1.8-2.0) years for all patients. By the end of 2-year follow-up, progression of vascular calcification (including CAC and AAC) was observed in 58.0% of patients. Further, compared with the patients without progression of vascular calcification, the endothelial injury (including E-selectin and sICAM-1) of patients with progression of vascular calcification was markedly enhanced. Moreover, after adjustment for the confounders, endothelial injury was a risk factor for the progression of vascular calcification.
The present study indicated that endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance hemodialysis.
血管钙化在慢性肾脏病患者中很常见且呈进行性发展。然而，维持性透析患者血管钙化进展的相关危险因素尚未完全阐明。在此，我们旨在评估维持性血液透析患者的血管钙化情况，并确定与其进展相关的因素。
这是一项前瞻性纵向研究，纳入了374例维持性血液透析患者。通过计算机断层扫描对参与者进行冠状动脉钙化（CAC）和腹主动脉钙化（AAC）评估。在基线调查后，进行了为期2年的随访。我们还检测了内皮损伤标志物[E-选择素和可溶性细胞间黏附分子-1（sICAM-1）]。最后，通过多因素逻辑回归分析检查影响CAC和AAC进展的危险因素。
在374例患者中，年龄中位数[四分位间距（IQR）]为54.0（40.0 - 62.0）岁；59.9%的患者为男性。所有患者的随访时间中位数（IQR）为1.9（1.8 - 2.0）年。到2年随访结束时，58.0%的患者出现了血管钙化进展（包括CAC和AAC）。此外，与无血管钙化进展的患者相比，血管钙化进展患者的内皮损伤（包括E-选择素和sICAM-1）明显增强。而且，在对混杂因素进行调整后，内皮损伤是血管钙化进展的一个危险因素。
本研究表明，内皮损伤是维持性血液透析患者血管钙化进展的危险因素之一。
