背景:本研究旨在探讨腹膜透析患者血管钙化的影响因素及其与长期预后的关系。
方法:这项回顾性队列研究包括在北京绿湖医院腹膜透析中心接受腹膜透析的慢性肾脏病患者,首都医科大学,从2019年1月到2019年3月。人口统计学和临床实验室数据,包括血清硬化蛋白(SOST),钙(Ca),磷酸盐(P),血清白蛋白(ALB),和完整的甲状旁腺激素(iPTH)水平,被收集。腹主动脉钙化(AAC)采用腹外侧X线检查,以确定血管钙化的发生。根据结果将患者分为AAC组和非AAC组。
结果:共91例患者纳入研究。AAC组由46名患者组成,而非AAC组由45例患者组成。与非AAC组相比,AAC组患者年龄明显较大(P<0.001),透析时间更长(P=0.004)。多因素logistic回归分析显示PD患者血管钙化的危险因素包括透析时间、糖尿病,高血压,和SOST。Kaplan-Meier生存分析显示,AAC组死亡率明显高于非AAC组(χ2=35.993,P<0.001)。多变量Cox回归分析显示,透析时间,糖尿病和AAC是腹膜透析患者全因死亡的危险因素.
结论:透析时间更长,共患糖尿病,高血压合并症,和SOST是PD患者血管钙化的危险因素。此外,AAC,透析时间更长,和共患糖尿病与腹膜透析患者全因死亡风险增加相关.
BACKGROUND: This study aims to investigate the influencing factors of vascular calcification in peritoneal dialysis (PD) patients and its relationship with long-term prognosis.
METHODS: This retrospective cohort study included chronic kidney disease patients undergoing peritoneal dialysis at the Peritoneal Dialysis Center of Beijing Luhu Hospital, Capital Medical University, from January 2019 to March 2019. Demographic and clinical laboratory data, including serum sclerostin (SOST), calcium (Ca), phosphate (P), serum albumin (ALB), and intact parathyroid hormone (iPTH) levels, were collected. Abdominal aortic calcification (AAC) was assessed using abdominal lateral X-ray examination to determine the occurrence of vascular calcification, and patients were divided into the AAC group and Non-AAC group based on the results.
RESULTS: A total of 91 patients were included in the study. The AAC group consisted of 46 patients, while the Non-AAC group consisted of 45 patients. The AAC group had significantly older patients compared to the non-AAC group (P < 0.001) and longer dialysis time (P = 0.004). Multivariable logistic regression analysis indicated that risk factors for vascular calcification in PD patients included dialysis time, diabetes, hypertension, and SOST. Kaplan-Meier survival analysis showed that the AAC group had a significantly higher mortality rate than the non-AAC group (χ2 = 35.993, P < 0.001). Multivariable Cox regression analysis revealed that dialysis time, diabetes and AAC were risk factors for all-cause mortality in peritoneal dialysis patients.
CONCLUSIONS: Longer dialysis time, comorbid diabetes, comorbid hypertension, and SOST are risk factors for vascular calcification in PD patients. Additionally, AAC, longer dialysis time, and comorbid diabetes are associated with increased risk of all-cause mortality in peritoneal dialysis patients.