Association of severity of conjunctival and corneal calcification with all-cause 1-year mortality in maintenance haemodialysis patients
Association of severity of conjunctival and corneal calcification with all-cause 1-year mortality in maintenance haemodialysis patients
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DOI：
10.1093/ndt/gfq485
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发表时间：
2011-03-01
影响因子：
6.1
通讯作者：
Lin, Ja-Liang
中科院分区：
文献类型：
--
作者：
Hsiao, Ching-Hsi;Chao, Anning;Lin, Ja-Liang
背景结膜和角膜钙化（CCC）是慢性肾衰竭患者最常见的转移性钙化形式。本研究的目的是调查CCC的严重程度是否与维持性血液透析（MHD）患者的血管钙化和死亡率相关。招募了109名MHD患者。CCC通过外眼照片进行评估，并根据Tokuyama等提出的改良Porter和Crombie分类系统进行分级和评分。胸部X线检查用于评估主动脉弓钙化。获得了地理、血液学、生物化学和透析相关数据。根据CCC的严重程度分层，分析患者的传统和非传统心血管疾病危险因素。所有患者随访1年，分析其死亡风险。基线时分别有43例、35例和31例患者有轻度CCC（评分= 9）。通过趋势估计，重度CCC患者的重度主动脉弓钙化百分比显著较高。多元线性回归分析显示，高血压、透析时间和校正钙水平与维持性血液透析患者CCC评分相关。此外，年龄、校正的钙磷水平、中度和重度CCC与主动脉弓钙化等级相关。1年随访时，109例患者中有11例（10.1%）死亡。多因素考克斯比例风险模型显示年龄、校正血钙和重度CCC是MHD患者1年全因死亡的显著危险因素。CCC每增加一分，全因死亡风险增加26.4%。CCC的严重程度，这是很容易在床边获得，作为一个独立的预测MHD患者的全因1年死亡率。
Background. Conjunctival and corneal calcification (CCC) is the most common form of metastatic calcification in patients with chronic renal failure. The aim of this study is to investigate if severity of CCC correlates with vascular calcification and mortality inmaintenance haemodialysis (MHD) patients.Methods. One hundred and nine MHD patients were recruited. CCC was evaluated by external eye photographs, and was graded and scored according to modified Porter and Crombie classification system described by Tokuyama et al. Chest X-ray examination was used to evaluate aortic arch calcification. Geographic, haematological, biochemical and dialysis-related data were obtained. The patients were analysed for traditional and non-traditional risk factors for cardiovascular disease stratified by severity of CCC. All patients were followed up for 1 year to investigate the risks for mortality.Results. Forty-three, 35 and 31 patients had mild (scores = 9) CCC at baseline, respectively. With trend estimation, patients with severe CCC had a significantly higher percentage of severe aortic arch calcification. Multiple linear regression analysis showed that hypertension, haemodialysis duration and corrected calcium level were associated with scores of CCC in MHD patients. Moreover, age, corrected calcium-phosphate level, and moderate and severe CCC were associated with grades of aortic arch calcification. At 1-year follow-up, 11 of 109 (10.1%) patients had died. Multivariate Cox proportional hazards model showed that age, corrected calcium and severe CCC were significant risk factors for all-cause 1-year mortality in MHD patients. Each increment of one score of CCC is associated with a 26.4% increased risk for all-cause mortality.Conclusions. Severity of CCC, which is easily obtained at bedside, acts as an independent predictor for all-cause 1-year mortality in MHD patients.