论文摘要:
Background Coronary artery calcification (CAC) contributes to high risk of cardiovascular mortality in ESRD patients. The present study aimed to identify modifiable risk factors for CAC initiation in PD patients.
Methods Adult patients received regular PD treatment and underwent a series of coronary artery calcification score (CaCS) measurements by multislice spiral computed tomography at baseline and semi-annual or annual repeat scans during the follow-up. The patients with baseline CaCS = 0 and were followed up for at least 3 years or until the conversion from absent to any measurable CAC detected were included in this observational cohort study. The demographic characteristics and clinical data, including laboratory data and adequacy of PD, were collected. Binary logistic regression was performed to identify the independent risk factor for CAC initiation in the PD patients.
Results A total of 70 adult patients on PD (36 men, 51.4%) with a mean age of 54.4 ± 13.4 years were recruited to this study. The patients were divided into a non-initiation group (n = 37) and an initiation group (n = 33) according to the conversion of any measurable CAC during their followed-up or not. The total follow-up time was 52.2 ± 17.2 months and the conversion of CAC in the initiation group were occurred in 36.5 ± 18.6 months. In univariate analysis, systolic blood pressure, serum phosphorus, fibrinogen, hs-CRP, serum creatinine and triglycerides were positive association with the initiation of CAC, while the high density lipoprotein (HDL) and nPCR did the opposite function. Multivariate logistic regression (forward conditional method) revealed that hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation after adjustments.
Conclusions Hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation in PD patients. These results provide important information for the clinical management of CAC in ESRD patients.