Thakker Tanvi V, Pursnani Lalit K, Mahapatra Himansu S, Bano Shahina, Balakrishnan Muthukumar, Binoy Renju, Suman Beauty, Alam Mahboob, Jha Abhishek
Department of Nephrology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, IND.
Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, IND.
Cureus. 2025 Feb 24;17(2):e79549. doi: 10.7759/cureus.79549. eCollection 2025 Feb.
Vascular calcification (VC) is known to be associated with higher cardiovascular risk in chronic kidney disease (CKD). However, its impact on morbidity factors like frailty and quality of life is understudied. This study aims to address this gap by assessing the correlation of VC with frailty and quality of life.
Consecutive patients with CKD stage 4 and 5, not on dialysis, were enrolled over one year. Pregnant patients and renal transplant recipients were excluded. VC was assessed using lateral abdominal radiographs, echocardiography, and cardiac computed tomography scans. Frailty was assessed using the Fried frailty phenotype. A Kidney Disease Quality of Life-36 (KDQoL-36) questionnaire was used for quality-of-life assessment which included physical, mental, and kidney disease-related components. We then investigated the relationships between VC, laboratory parameters, quality of life, and frailty.
A total of 202 patients were enrolled, of which, 26% of patients had detectable VC. Older age, smoking, and coronary artery disease were associated with higher prevalence of VC. Stage of CKD or mineral bone disease markers did not show any significant difference between patients with and without VC. Individuals with VC were significantly more likely to be frail than those without (57.4% vs 30.4%, p-value- 0.001). Patients with VC had significantly lower quality of life scores as compared to those without VC (physical component scores - 45.84±18.98 vs 62.34±22.06; mental component scores - 51.18±20.17 vs 65.99±23.75; kidney disease component scores - 64.90±13.65 vs 74.28±16.32, p-value <0.001).
Patients with VC showed higher prevalence of frailty and significantly impaired quality of life. This highlights the profound clinical implications of VC on functional decline in CKD patients.
血管钙化（VC）与慢性肾脏病（CKD）患者较高的心血管疾病风险相关。然而，其对衰弱和生活质量等发病因素的影响研究较少。本研究旨在通过评估VC与衰弱及生活质量的相关性来填补这一空白。
连续纳入1年内未接受透析的4期和5期CKD患者。排除孕妇和肾移植受者。使用腹部侧位X线片、超声心动图和心脏计算机断层扫描评估VC。使用弗里德衰弱表型评估衰弱。采用肾脏病生活质量-36（KDQoL-36）问卷进行生活质量评估，该问卷包括身体、心理和肾脏病相关部分。然后我们研究了VC、实验室参数、生活质量和衰弱之间的关系。
共纳入202例患者，其中26%的患者可检测到VC。年龄较大、吸烟和冠状动脉疾病与VC的较高患病率相关。CKD分期或矿物质骨病标志物在有和无VC的患者之间未显示出任何显著差异。与无VC的个体相比，有VC的个体明显更易衰弱（57.4%对30.4%，p值 = 0.001）。与无VC的患者相比，有VC的患者生活质量得分显著更低（身体成分得分 - 45.84±18.98对62.34±22.06；心理成分得分 - 51.18±20.17对65.99±23.75；肾脏病成分得分 - 64.90±13.65对74.28±16.32，p值<0.001）。
有VC的患者衰弱患病率更高，生活质量显著受损。这突出了VC对CKD患者功能衰退的深远临床意义。
