Study On The Relationship Between TCM Syndrome And Cardiovascular Events Of Chronic Kidney Disease

Objectives:We discuss the risk factors for cardiovascular events in the non-dialysis Chronic Kidney Disease patients in our hospital and analyze the relationship between the cardiovascular events and the syndrome of traditional Chinese medicine. Thus we can provide theoretical basis for clinical prevention and treatment which combine traditional Chinese and western medicine for patients who was on the high risk of reaching cardiovascular events.Methods:The research object were the patients with chronic kidney disease that be treated in Hubei Provincial Hospital Of Traditional Chinese Medical from February, 2012 to February, 2013, and everyone signed the informed consent.There were 157 patients qualified.Baseline data, including carotid arteries intima-media thickness, relative laboratory index were collected. Every was follow-up at the 12 month, 24 month and 36 month, except outcome event occur(renal end point, cardiovascular disease end point,death). We consider the censored data as did not appear the cardiovascular event in the end of the study. 157 cases divided into cardiovascular events group and non cardiovascular events group. Recorded patients’ general information(including gender, age,primary disease,etc), and relative laboratory index, including hemoglobin(HB), intact parathyroid hormone(i PTH), glycosylated hemoglobin(Hb A1C),albumin(Alb),triglyceride(TG), total cholesterol(TC), high density lipoprotein-cholesterol(HDL-C), low density lipoproteincholesterol(LDL-C), serum creatinine concentration(Scr), uric acid(UA), calcium(Ca), phosphorus(P) and the syndrome of traditional Chinese medicine.COX-regression model is applied to analysis risk factors for cardiovascular events in the non-dialysis Chronic Kidney Disease patients.Results:1.There were 157 cases of patients with CKD 1th—4thstage, including87 males(55.4%)and 70 females(44.6%).The follow-up visit duration 36 months, the mean duration was(32.3±7.9) months.As the study is completed, six cases lost to follow, twenty-five cases arrived kidney end point, seventeen cases arrived cardiovascular event end point and four cases died(1 died of kidey event, 3 died of cardiovascular event).There was no significant difference in age and sex between the two groups.2.The cardiovascular event group mean carotid arteries intima-media thickness was(1.000±0.195)mm, and higher than the non cardiovascular event group(P=0.000). We compared the 157 cases’ carotid arteries intima-media thickness at the baseline and 109cases’ who were not run into the end point as the study is completed,but no difference was found.3.The cardiovascular event group mean hemoglobin was(114.84± 25.63)g/L, while the non cardiovascular event group was(126.16±21.15) at the baseline, there exited significant difference by statistic(P=0.044).4.COX single factor regression analysis shows that anemia, hyperparathyroidism, higher carotid arteries intima-media thickness and the syndrome of traditional Chinese medicine could endanger the patients of CKD into cardiovascular events. On the other hand, the age, gender, HBA1c、Alb、TG、TC、e GFR、UA、P and Ca has no obvious correlation with cardiovascular events in CKD patients.5.A multivariate COX proportional hazards regression analysis via step forward LR methods shows that risk factors correspond with cardiovascular events in patients of CKD was anemia(b>0,HR>1) with the HR was 1.648,and the higher carotid arteries intima-media thickness was the risk factor with the HR was 2.250.Conclusions:1.There is a high prevalence of cardiovascular events in CKD patients, anemia, hyperparathyroidism, higher carotid arteries intima-media thickness and the syndrome of traditional Chinese medicine were associated with cardiovascular events.2.Hemoglobin and carotid arteries intima-media thickness were reliability indicator of cardiovascular events on CKD patients over a 36 months follow-up period.