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The relation of calcium-phosphorus metabolism-related indexes with cardiac damages
1Department of Urology, Central Hospital, Xu Zhou, Jiangsu Province, China. wuling001@sina.com.
Insights
Calcium-phosphorus metabolism disorders in chronic kidney disease (CKD) are linked to cardiac damage. Elevated levels of certain metabolism markers correlate with myocardial hypertrophy and impaired cardiac function in CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Chronic kidney disease (CKD) is associated with significant cardiovascular complications.
- Disruptions in calcium-phosphorus metabolism are common in CKD patients and may impact cardiovascular health.
Purpose of the Study:
- To investigate the relationship between calcium-phosphorus metabolism markers and cardiac damage indicators in non-dialyzed CKD patients.
- To explore the role of disturbed calcium-phosphorus metabolism in the pathogenesis of cardiac damage in CKD.
- To provide insights for preventing cardiovascular events in CKD.
Main Methods:
- A cohort of 98 non-dialyzed CKD patients (stages 3-5) was recruited.
- Serum levels of calcium, phosphate (Pi), intact parathyroid hormone (iPTH), β-collagen-specific sequences (β-CTX), total N-terminal propeptide of type I procollagen (TPINP), and N-terminal-mid fragment of osteocalcin (N-MID) were measured.
- Echocardiography assessed cardiac structure (e.g., left ventricular end diastolic diameter, interventricular septal thickness) and function (ejection fraction, mitral inflow velocities).
- Correlation analysis was performed between metabolism and cardiac indexes.
Main Results:
- Calcium-phosphorus metabolism markers showed an increasing trend from CKD stage 3 to stage 5.
- Myocardial hypertrophy was observed in 35.9% of patients, diastolic dysfunction in 72.1%, and systolic dysfunction in 27.5%.
- Levels of β-CTX, N-MID, TP1NP, Pi, and iPTH were positively associated with myocardial hypertrophy and negatively associated with cardiac systolic (ejection fraction) and diastolic function (A/E value).
Conclusions:
- Disorders of calcium-phosphorus metabolism in CKD patients are associated with structural and functional cardiac damage.
- These findings highlight the potential contribution of mineral and bone disorder to cardiovascular complications in CKD.
Objective:
To observe and analyze the relation of calcium-phosphorus metabolism-related indexes with cardiac damage-related indexes in patients with chronic kidney disease (CKD) and to explore the roles of calcic and phosphor metabolization in cardiac damage and provide references for prevention of cardiovascular events in CKD patients.
Patients And Methods:
A total of 98 inpatients, from Urology Department, who were not undergoing dialysis treatment and diagnosed with stages 3, 4, and 5 CKD according to K/DOQI guide were recruited. We measured the calcium-phosphorus metabolism-related indexes (including serum calcium (Ca), the serum phosphate (Pi), the intact parathyroid hormone (iPTH), the β-collagen-specific sequences (β-CTX), the total N-terminal propeptide of type I procollagen (TPINP), the N-terminal-mid fragment of osteocalcin (N-MID), the cardiac damage-related indexes (including left ventricular end diastolic diameter (LVEDD), the interventricular septal thickness (IVST), the left ventricular posterior wall thickness (LVPWT), the ejection fraction (EF), the blood flow velocity at mitral diastolic late phase (A) and mitral diastolic early phase (E) via echocardiography. Then, we conducted a correlation analysis employing these two types of indexes.
Results:
We found an escalating trend in the level of calcium-phosphorus metabolism-related indexes from stage 3 to stage 5 CKD. The difference between stage 3 and 5 is statistically significant (p < 0.05) while that between stage 3 and 4 is not (p > 0.05). Among 98 CKD patients, the myocardial hypertrophy accounted for 35.9% (n = 36), the diastolic dysfunction accounted for 72.1% (n = 70), and systolic dysfunction accounted for 27.5% (n = 27). Levels of β-CTX, N-MID, TP1NP, Pi, and iPTH are positively associated with the myocardial hypertrophy and yet negatively associated with cardiac systolic (EF) and diastolic function (A/E value).
Conclusions:
Calcium-phosphorus metabolism disorder in the context of kidney dysfunction may contribute to the damages of cardiac structure and functions.
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