Investigation And Analysis On Related Factors Of Abdominal Aortic Calcification In Patients With Maintenance Hemodialysis

Objective According to the previous study,we found that the incidence of abdominal aortic calcification was high in patients undergoing maintenance hemodialysis(MHD).This study is to explore the factors associated with abdominal aortic calcification,and provide new ideas for the prevention and treatment of vascular calcification in maintenance hemodialysis patients.Methods In this study,72 MHD patients were included,and the enrollment requirements of the patients were as follows: older than 18-year-old;duration of MHD treatment ≥ 6 months;weekly hemodialysis for 10-12 h;Kt/V ≥ 1.2;without serious diseases or haparathyroid dysfunction were treated by surgery in the last 3 months,or had been treated with calciferol or calcimimetic in the last 3 months.The demographic characteristics,relevant clinical and experimental examination data of the patients were recorded,including age,duration of dialysis,gender,primary disease diagnosis,blood pressure and blood calcium,blood phosphorus,albumin(ALB),hemoglobin(Hb),C reactive protein(CRP),alkaline phosphatase(ALP)and intact parathyroid hormone(i PTH).More over,the levels of serum sclerostin and Interleukins(IL)-37 were detected by ELISA.The extent of abdominal aortic calcification was assessed by abdominal lateral radiograph and semi-quantitative method.In accordance with the abdominal aortic calcification score(AACs),the MHD patients were divided into patients without/with light AAC(AACs≤ 3)and patients with moderate-severe AAC(AACs>3).Statistical analysis was performed on the correlation of each parameter with SPSS 19.0.When P<0.05,there was statistically significant.Results 1.The average age of all the 72 patients(including 48 males and 24 females)with MHD was 58.2±13.2,and the average duration of dialysis was 48.3±30.5 months.The primary disease was chronic glomerulonephritis in 27 cases(37.6%),diabetic nephropathy in 14 cases(19.4%),hypertensive nephropathy in 20 cases(27.8%),and other diseases in 11 cases(15.2%).2.A total of 53 patients with abdominal aortic calcification were enrolled,accounting for 73.6%,including 11 cases of light AAC(15.27%),29 cases of moderate AAC(40.27%),and 13 cases of severe AAC(18.06%).3.The age,dialysis duration,serum calcium,serum phosphorus,ALP,CRP and i PTH of the patients with moderate-severe AAC were significantly higher than those in the patients without/with light AAC,and the difference was statistically significant(P<0.05).4.The serum sclerostin [2874.46(2317.72,5 482.97)] ng/L of the patients with moderate-severe AAC were significantly higher than the serum sclerostin [2298.53(1868.51,3360.15)] ng/L of the patients without/with light AAC,and the difference was statistically significant(P<0.05).The serum sclerostin were positively correlated with AACs(r=0.351,P=0.003),and the differences were statistically significant(P<0.05).5.The serum IL-37 [71.04(49.76,158.67)] ng/L of the patients with moderate-severe AAC were significantly higher than the serum IL-37 [55.96(44.34,75.24)]ng/L of the patients without/with light AAC,and the difference was statistically significant(P<0.05).The serum IL-37 were positively correlated with AACs(r=0.266,P=0.024),and the differences were statistically significant(P<0.05).6.The results of Logistic regression analysis showed that advanced age,hypercalcemia and the increase of i PTH were the independent risk factors for morderate-severe calcification of abdominal aorta in MHD patients(P<0.05).Conclusion 1.The incidence of AAC in patients with maintenance hemodialys is higher,reaching 73.6%,and the degree of calcification is heavier.2.The serum sclerostin and interleukin-37 were significantly elevated in patients with moderate-to-severe AAC,and the serum sclerostin and interleukin-37 is positively correlated with AACs,suggesting serum sclerostin and interleukin-37 can play a role in the development of vascular calcification in maintenance hemodialysis patients.3.Advanced age,hypercalcemia,and increased i PTH level are independent risk factors for morderate-severe calcification of abdominal aorta in patients with maintenance hemodialysis.