Effect Of Parathyroid Hormone On Abdominal Aortic Calcification In Maintenance Hemodialysis Patients

ObjectiveTo investigate the risk factors of abdominal aortic calcification(AAC) for maintenance hemodialysis(MHD) patients.MethodsThe lateral X-ray plain films of abdomen were used for AACs evaluation in MHD patients.177 MHD patients were divided into calcified group(AACs>0)and non-calcified group(AACs=0).The demographic characteristics,dialysis vintage,clinical history as cardiovascular vents,hypertension,hyperlipidemia,diabetes,medication history of calcium carbonate and active vitamin D,laboratory markers as serum alcium,phosphorus,intact parathyroid hormone(PTH) and hypersensitive c-reactive protein(HSCRP) were compared between the two groups.The risk factors of AACs were analyzed by Logistic regression model.The probability of AACs among patients with different level of PTH was evaluated.ResultsThere are 103(58.2%) MHD patients with AACs,The incidence of cardiovascular events was significantly higher in calcified group compared with non-calcified group(33.3% Vs 9.4%).The results of univariable analysis showed that the number of patients with aging,longer history of dialysis,higher levels of HSCRP,history of hyperlipidemia or hypertension, medication history of calcium carbonate or nonselective active vitamin D in calcified group was more than that in non-calcified group.Thedifference was statistically significant.The results of Logistic regression analysis showed that aging,hyperlipidemia, hypertension,longer dialysis vintage,higher PTH and HSCRP levels,medical history of nonselective active vitamin D or calcium carbonate were risk factors of AACs.Serum PTH level was positively correlated with the incidence of AACs even after adjusted by age,gender,smoking,dialysis vintage,history of hypertension or diabetes,high HSCRP,medication history of nonselective active vitamin D or calcium carbonate.The area under the ROC curve of Raditional cardiovascular risk factors and those risk factors related chronic kidney disease in the diagnosis of abdominal aortic calcification of is 0.86.ConclusionThe incidence of AACs is higher in MHD patients,which might affect the prognosis of cardiovascular events. Aging, hyperlipidemia,hypertension,dialysis vintage,higher HSCRP,nonselective active vitamin D and calcium carbonate use are risk factors of AACs.The higher levesl of PTH might be one of the most important risk factors of AACs for MHD patients.