| Background The coronary heart disease is one of the most common chronic disease harm to human health, in our country, the incidence of CHD increased year by year, has gradually become the main diseases of harm people’s health. Chronic kidney diseases and coronary heart disease has some common in pathogenesis.Its prevalence showed a trend of sustained growth in the global scope. CKD sustained progress eventually lead to end-stage renal disease and related complications. CHD has become a major cause of death for patients with chronic kidney disease. Many patients with chronic kidney disease death from cardiovascular disease before progress to ESRD stage. With the progress of chronic kidney disease, incidence of CHD gradually rising, that harm to patients’ health, increase the economic burden. Even after renal transplantation, the probability of patients with cardiovascular disease remains high. Coronary angiography is an important method of examination and treatment of CHD, in patients with chronic kidney disease combined CHD is also important. This research through the diagnosis of CHD were retrospectively analyzed characteristics and risk factors of coronary artery lesions in patients with chronic kidney disease, analysis of the relationship between coronary stenosis and kidney function. To evaluate whether coronary angiography using contrast agent affect renal function in patients with renal transplantation.Objective To investigate the related risk factors of CAD in patients with CKD. Analyse the relationship between Coronary stenosis level and renal function. Investigate using contrast agents in coronary angiography whether affect renal function in renal transplant patients.Methods From January,2007 to December,2014, 79 patients in our hospital underwent coronary angiography with CKD. Divided into 3 groups according to renal function and the treatment of CKD. By collecting the results of medical history,coronary angiography report and blood biochemical indicators of the patients, we tried to explore the relationship relationship between Coronary stenosis level and renal function. Investigate using contrast agents in coronary angiography whether affect renal function in renal transplant patients.Results(1) General data There were total 61 males of 79 cases. And 27 patients of mild to moderate renal insufficiency(group A),31 patients of maintenance hemodialysis(group B) and 21 patients of renal transplant(group C), respectively. The average age were 63.74±8.99,54.39±10.16,54.29±6.94, respectively. The group A patients is elder than other groups. There were no significant difference of hypertension, diabetes mellitus and dyslipidemia in 3 groups.(2) Angiography report There is no significant difference of left main of coronary artery lesions and triple-vessel lesions in 3 groups. The most common lesion was in left anterior descending of coronary artery. The incidence of diffuse lesions and Gensini score were higher significantly in group B than others(P < 0.05). The estimated glomerular filtration rate(e GFR) was significantly correlated with Gensini score(r=-0.32, P <0.05). Three groups of patients that underwent percutaneous coronary intervention(PCI) were 16, 20 and 17,respectively, cases of three groups of PCI therapy has no obvious difference(p = 0.215). The average number of stent placement for three groups was 2.47 ±1.33, 4.07 ± 2.15, 2.79 ±0.91, respectively. the average number of stent placement in three groups have significantly difference(p < 0.05), group B is higher than others.For patients with severe coronary artery lesions that suggested underwent coronary artery bypass grafting(CABG), in three groups were 1, 3 and 1,respectively, the proportion of three groups of patients with CABG have no obvious difference(p = 0.85).(2) The renal transplant patients serum creatinine before and after coronary angiography day3 and day7 were 123.33±64.60, 128.36±57.49 and 123.22±64.48umol/L, respectively. The urea were 8.93±3.84, 9.12±3.43 and 8.11±2.66mmol/L, respectively. There were no significantly difference between serum creatinine and urea before and after coronary angiography.Conclusion(1) With the decreasing in renal function of CKD patients, the Gensini score and diffuse lesions is hihger, the number of stent when underwent PCI is incersed, the e GFR was significantly correlated with Gensini score.(2) Renal transplant patients was safety in use contrast agent with active protection measures. |
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