Increased Prevalence and Severity of Coronary Artery Calcification in Patients with Chronic Kidney Disease Stage III and IV.
Increased Prevalence and Severity of Coronary Artery Calcification in Patients with Chronic Kidney Disease Stage III and IV.
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DOI：
10.1159/000339786
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发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Goumenos DS
中科院分区：
文献类型：
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作者：
Koukoulaki M;Papachristou E;Kalogeropoulou C;Papathanasiou M;Zampakis P;Vardoulaki M;Alexopoulos D;Goumenos DS
心血管疾病（CVD）是慢性肾病（CKD）患者死亡的主要原因。CKD中冠状动脉疾病的病理生理学是多因素的，除了传统的风险因素（高血压、高脂血症、糖尿病）外，还包括与尿毒症相关的参数。该研究包括测量无CVD病史的CKD III期和IV期患者的冠状动脉钙化（CAC）评分，以及使用多探测器计算机断层扫描的年龄，性别和风险因素匹配的正常肾功能对照组。该研究包括49名患者和49名对照。CKD组中CAC的存在率为79.6%，对照组为59.2%（p = 0.028）。CKD患者的中位CAC评分值为139（四分位距（IQR）：23-321），对照组为61（IQR：6-205）（p = 0.007）。CAC与传统的危险因素相关，如老年、高血压和基线心血管风险评分，而重度钙化的CKD患者的估计肾小球滤过率略低，甲状旁腺素水平升高。与肾功能正常的匹配对照相比，CAC在CKD III期和IV期患者中更常见和更严重，即使肾脏疾病相关参数与钙化强度不直接相关。
Cardiovascular disease (CVD) is the main cause of mortality in patients with chronic kidney disease (CKD). The pathophysiology of coronary artery disease in CKD is multifactorial including, in addition to traditional risk factors (hypertension, hyperlipidemia, diabetes mellitus), parameters related to uremia. The study consisted of measuring coronary artery calcification (CAC) score in patients with CKD stage III and IV without history of CVD and in a group of controls with normal renal function matched for age, gender and risk factors using multi-detector computed tomography. The study included 49 patients and 49 controls. CAC was present in 79.6% in the CKD group versus 59.2% in the control group (p = 0.028). The median CAC score value in CKD patients was 139 (interquartile range (IQR): 23–321) versus 61 (IQR: 6–205) in controls (p = 0.007). CAC was associated with traditional risk factors such as older age, hypertension and baseline cardiovascular risk score, while CKD patients with severe calcification had marginally lower estimated glomerular filtration rate and increased levels of parathormone. CAC is more frequent and severe in patients with CKD stage III and IV compared to matched controls with normal renal function, even though kidney disease-related parameters are not directly correlated with intensity of calcification.