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Analysis of Trends in Coronary Artery Calcification and Its Correlative Factors in Renal Transplant Recipients

Author: HeGuiFang
Tutor: ZhangXinZhou
School: Jinan University
Course: Internal Medicine
Keywords: Kidney Transplantation Cardiovascular Coronary Calcify Risk Factors Fetuin A Hyperlipidemia
CLC: R699.2
Type: Master's thesis
Year: 2011
Downloads: 21
Quote: 0
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Abstract


Objective: To investigate renal transplant coronary artery calcification (CAC) of the relevant factors and trends. Methods: 46 cases of renal transplant patients underwent coronary multislice spiral CT (MSCT) scanning, calculating CAC points, divided into groups with and without CAC CAC group, while collecting clinical information and serum fetuin-A (Fetuin A), serum creatinine, blood lipids, high-sensitivity C-reactive protein (HsCRP) and other laboratory parameters. Number of biochemical markers in both groups were compared using two inter-sample t test. CAC influencing factors using non-conditional logistic regression analysis. Follow-up 12 months after the detection of the line again. For 12 months before and after the number of biochemical parameters were compared between the paired t-test line, for 12 months before and after the CAC scores were compared between the number of line pairs signed rank test data, analyze CAC trends and influencing factors. Results: CAC group (15 cases, 32.61%) and non-CAC group (31 cases, 67.39%) in age, duration of dialysis, HsCRP, Fetuin A, low-density lipoprotein (LDL), calcium, etc. There was a significant difference ( both P lt; 0.05). The levels of serum Fetuin A CAC group (0.27 0.04) g / L, significantly lower than those without CAC group [(0.34 0.07) g / L, P lt; 0.05]. Non-conditional logistic regression analysis showed: Age (OR = 1.20, P = 0.02) and LDL (OR = 4.26, P = 0.01) was an independent risk factor for CAC. CAC score and Fetuin A negative correlation (r = -0.48, P lt; 0.05), and age (r = 0.51, P lt; 0.05), duration of dialysis (r = 0.35, P lt; 0.05), LDL (r = 0.66, P lt; 0.05), calcium (r = 0.38, P lt; 0.05), HsCRP (r = 0.48, P lt; 0.05) were positively correlated. Fetuin A levels and HsCRP (r = -0.57, P lt; 0.05), the age (r = -0.30, P lt; 0.05) was negatively correlated with serum calcium, phosphorus, calcium-phosphorus product, parathyroid hormone (PHT ), high density lipoprotein (HDL), cholesterol (CHOL), triglyceride (TG), LDL was no significant correlation (P all gt; 0.05). Follow-up 12 months later there were 39 cases of renal transplant patients [CAC group (14 cases, 35.90%), non-CAC group (25 cases, 64.10%)] to accept detected again, HsCRP, TG levels than 12 months ago, was significantly increased (P lt; 0.05), HDL levels than 12 months ago, was significantly decreased (P lt; 0.05). CAC scores than 12 months were significantly increased, CAC increased from 21.59 ± 54.64 points increased to 37.15 ± 71.43 (Z = 3.622, P lt; 0.05). CAC integral average annual rate of change of 15.56 ± 46.42. The follow-up 12 months later, CAC CAC integration majority of patients has increased, its CAC score was 98.90 ± 91.87. No CAC group had 20 cases (80.00%) patients are still not happened CAC, 5 patients (20.00%) had CAC, CAC score of its 12.88 ± 7.80. CONCLUSION: Renal transplant patients CAC score and age, duration of dialysis, HsCRP, LDL, calcium and other factors were positively correlated with Fetuin A levels were negatively correlated. Age and LDL are independent risk factors for CAC. Serum Fetuin A levels and HsCRP, Age was negatively correlated. CAC occurrence is the result of a combination of factors. CAC in renal transplant patients overall trend is upward. Infection, HDL and TG reduction may be elevated in patients with renal transplantation accelerated vascular calcification is one important factor. Infection control, regulate blood lipids, shortening duration of dialysis before transplantation may slow the progress of calcification. Synthesis of endogenous calcification inhibitors Fetuin A may be used as the treatment of patients with vascular calcification provide new ways and methods.

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Urinary tract and male reproductive system surgery > Kidney surgery
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