Screening of risk factors for the structure and function of heart in maintenance hemodialysis patients / 中国医师杂志

ABSTRACT

Objective To investigate the correlations between plasma indoxyl sulfate and p-cresyl sulfate in the pathogenesis of cardiovascular complications in maintenance hemodialysispatients.Methods A total of 145 maintenance hemodialysis patients were selected.The researchers measured the physiological parameters of the subjects,including pre albumin,albumin,hemoglobin,blood urea nitrogen,creatinine,uric acid,calcium,phosphorus,alkaline phosphatase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density fat cholesterol,intact parathyroid hormone,C-reactive protein,apolipoprotein,lipoprotein,homocysteine,beta 2-microglobulin,sulfuric acid indoxyl,sulfuric acid cresol,serum iron,transferrin,ferritin,and N-terminal pro brain natriuretic peptide carrier.Subjects underwent cardiac ultrasound examination.Results The researchers used heart structure and function as the dependent variable.The single factor Cox regression analysis showed that the risk of heart structure and function changes increased with the increase of systolic blood pressure,N-terminal B-type natriuretic peptide,and left ventricular mass index.This study also showed that the risk of heart structure and function changes in patients with previous history of coronary heart disease also increased.The researchers took the systolic blood pressure,coronary heart disease history,N-terminal brain natriuretic peptide,and the left ventricular mass index as the dependent variables.Multifactor Cox regression analysis showed that the history of coronary heart disease,the high left ventricular mass index and the change of the heart structure and function of the patients with acute coronary heart disease were the independent predictors of the change of heart structure and function.The researchers used cardiovascular complications as the dependent variable.Cox regression analysis showed that,with the increase in patient's age,dialysis duration,elevated high C-reactive protein and sulfuric acid p-cresol,patients suffering from the risk of fatal cardiovascular complications rise.The researchers used the complications of cardiovascular deaths as dependent variable,age,duration of dialysis,C-reactive protein,and sulfuric acid p-cresol as covariates,multivariate Cox regression analysis of the results showed that with increasing age,dialysis duration increased,high sulfate of cresol and C-reactive protein,patients suffering from the risk of death from cardiovascular complications rise.Conclusions The history of coronary heart disease,left ventricular mass index,systolic blood pressure,indoxyl sulfate,Nterminal brain natriuretic peptide,age,dialysis age,high C-reaction protein,and p-cresol sulfate are the independent risk factors for cardiovascular complications.The relationship between indoxyl sulfate and sulfuric acid serum concentration of p-cresol and adverse cardiovascular events is most closely.