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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Mineral and Bone Disorder and Its Association with Cardiovascular Parameters in Chinese Patients with Chronic Kidney
Chu Zhou1, Fang Wang2, Jin-Wei Wang2
1Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing 100034; Guizhou Medical University, Guiyang, Guizhou 550004, China.
Insights
Hyperphosphatemia is common in Chinese predialysis CKD patients, with suboptimal phosphate binder use. Elevated serum phosphorus is linked to abdominal aortic calcification and left ventricular hypertrophy.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Mineral and bone disorder (MBD) and hyperphosphatemia are risk factors in chronic kidney disease (CKD).
- CKD-MBD in the Chinese population remains understudied.
- This study investigates MBD status and cardiovascular links in Chinese predialysis CKD patients.
Purpose of the Study:
- To assess the prevalence of MBD markers in Chinese predialysis CKD patients.
- To examine the association between MBD, specifically hyperphosphatemia, and cardiovascular parameters like abdominal aortic calcification (AAC) and left ventricular hypertrophy (LVH).
Main Methods:
- Utilized data from the prospective, multicenter Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE).
- Measured serum phosphorus, calcium, and intact parathyroid hormone at baseline.
- Employed logistic regression models to analyze associations between serum phosphorus, AAC, and LVH.
Main Results:
- Included 3194 predialysis CKD patients; hyperphosphatemia prevalence increased with CKD stage, reaching 27.1% in Stage 5.
- 71.6% of hyperphosphatemic patients did not receive phosphate binders (PBs).
- Serum phosphorus was independently associated with AAC (9.8% prevalence) and LVH (13.2% prevalence).
Conclusions:
- Hyperphosphatemia prevalence in Chinese CKD patients is comparable globally, but PB usage is suboptimal.
- Vascular calcification prevalence appears lower in Chinese patients than in Caucasian populations.
- Elevated serum phosphorus is a significant risk factor for cardiovascular complications in this cohort.
Background:
Mineral and bone disorder (MBD), especially hyperphosphatemia, is an independently risk factor for adverse prognosis in patients with chronic kidney disease (CKD). However, CKD-MBD among Chinese population was poorly studied. This study aimed to investigate the status of MBD and its association with cardiovascular parameters in Chinese patients with predialysis CKD.
Methods:
Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) is a prospective multicenter cohort study involving predialysis CKD patients in China. Markers of MBD, including serum phosphorus, calcium, and intact parathyroid hormone, were measured in baseline samples at the patients' entry. The association between serum phosphorus and abdominal aortic calcification (AAC), left ventricular hypertrophy (LVH) were examined by logistic regression models.
Results:
Altogether 3194 predialysis patients with mean estimated glomerular filtration of 51.8 ± 33.1 ml.min-1.1.73 m-2 were included. The proportion of patients with hyperphosphatemia were 2.6%, 2.9%, 6.8%, and 27.1% in CKD Stages 3a, 3b, 4, and 5, respectively. Moreover, 71.6% of the patients with hyperphosphatemia did not receive any phosphate-binder (PB). Lateral abdominal X-rays were obtained in 2280 patients, 9.8% of the patients were diagnosed as having AAC. Altogether 2219 patients had data of echocardiography, and 13.2% of them were diagnosed with LVH. Multivariate logistic regression analysis showed that serum phosphorus was independently associated with the presence of AAC and LVH.
Conclusions:
In Chinese patients with CKD, the percentage of hyperphosphatemia is comparable to that of other countries while the usage of PBs is suboptimal. The prevalence of vascular calcification in Chinese patients is relatively lower compared with the Caucasian population.
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