The Evolution Of Cardiovascular Calcification In Peritoneal Dialysis Patients And Its Clinical Significance

OBJECTIVE:To dynamically observe the morbidity and evolution of cardiovascular calcification in patients with peritoneal dialysis(PD),and to analyze the factors influencing calcification and the clinical significance of cardiovascular calcification.METHODS:A total of 150 PD patients were enrolled in a prospectively study.Assess baseline clinical features and the morbidity of cardiovascular calcification.Follow-up for 30 months.An imaging evaluation of calcification was performed at 0,12 and 24 months,respectively.The Logistic regression was used to analysis factors affecting cardiovascular calcification and progression.The Kaplan-Meier method was used to calculate the all-cause mortality,cardiovascular disease(CVD)mortality and nonfatal cardiovascular events(CVE).And the risk factors were analyzed by COX regression analysis.RESULTS:57.3%of patients had calcification at baseline,and at the end of follow-up,the cardiovascular calcification rate rose to 63.2%.Calcification progression was observed in 53.5%of patients.5.3%of petients died during follow-up,and the most common cause of death was CVD(75%).The morbidity of CVE was 19.3%.The all-cause mortality(p = 0.004)and CVD mortality(p = 0.002)were significantly higher in patients with clinically significant calcification than in other patients,Hypoalbuminemia and mitral calcification are independent risk factors for all-cause mortality and CVD mortality.Age>46 years,low-density lipoprotein cholesterol and coronary artery calcification with cardiac valve calcification are independent risk factors for CVE.Conclusion:PD patients had high morbidity of cardiovascular calcification and the progression of calcification is rapid.Cardiovascular calcification is closely related to the occurrence of CVD,and it has negative effects on prognosis.