Risk factors of cardiovascular and cerebrovascular accidents in patients undergoing maintenance hemodialysis / 中华全科医师杂志

ABSTRACT

Objective:To investigate the risk factors of cardiovascular and cerebrovascular events in patients undergoing maintenance hemodialysis (MHD).Methods:A total of 285 patients undergoing MHD in the Blood Purification Center of Yixing People′s Hospital from May 2013 to March 2018 were enrolled, including 137 patients with cardiovascular and cerebrovascular events and 148 patients without cardiovascular and cerebrovascular events. The demographic and clinical data of patients were retrospectively reviewed. The age, systolic blood pressure, duration of dialysis and prevalence of atherosclerosis were compared between the two groups; the risk factors of cardiovascular and cerebrovascular events were analyzed by multivariate logistic regression.Results:There were significant differences in age, systolic blood pressure, duration of dialysis and prevalence of atherosclerosis; serum creatinine, serum phosphorus, hs-CRP and triglyceride levels between the two groups ( P<0.05). Multivariate logistics analysis showed that age ≥50 years ( B=0.42, 95 %CI 1.06-3.06, P=0.03), duration of dialysis≥24 months ( B=0.85, 95 %CI 1.23-3.79, P=0.01), atherosclerosis ( B=0.58, 95 %CI 1.13-4.02, P=0.04), hypertension ( B=0.23, 95 %CI 1.34-9.25, P<0.01), diabetic kidney disease (DKD) ( B=0.36, 95 %CI1.19-8.27, P<0.01) , increased hs-CRP ( B=0.83, 95 %CI 1.12-3.90, P<0.01), high serum phosphorus ( B=0.91, 95 %CI 1.06-1.54, P<0.01) and elevated TG ( B=0.50, 95 %CI 1.08-5.57, P<0.01) were independent risk factors for cardiovascular and cerebrovascular events in MHD patients. Early and active intervention of these risk factors may improve the clinical prognosis of MHD patients. The Cox survival curve showed that the probability of cardiovascular and cerebrovascular events increased when the duration of dialysis was>12 months, and it increased more significantly when the duratio n>24 months. Conclusion:The older age, dialysis duration, comorbidities of atherosclerosis, hypertension, DKD, and elevated serum hs-CRP, phosphorus, triglyceride may increase the probability of cardiovascular and cerebrovascular events for MHD patients.