Calcium‒Phosphorus Metabolism in Chronic Kidney Disease and Its Relationship with Vascular Calcification.

IF 2.1 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2025-09-14 DOI:10.1159/000548408

Lei Ran, Xiaoxi Wu, Li Guo, Yapu Zhang, Lei Wang, Tingting Cai, Youlan Gong

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引用次数: 0

Abstract

Objective: To explore bone metabolism in chronic kidney disease (CKD) and its correlation with nutritional indicators and to identify risk factors for abdominal aortic calcification (AAC).

Methods: This cross-sectional study enrolled 148 adults (>18 years) with CKD stages 3-5 (stage 3: n=13, stage 4: n=15, stage 5: n=120 including dialysis and non-dialysis patients) between May 2018 and May 2021. Participants met strict criteria: confirmed CKD diagnosis per Kidney Disease Outcomes Quality Initiative guidelines, stable nutritional status without malabsorption disorders and no vitamin K antagonist use. Exclusion criteria included acute kidney injury, transplant recipients, malignancies and thyroid/parathyroid disorders. Using convenience sampling, we assessed correlations between nutritional/mineral markers via Pearson's analysis and identified intima-media thickness (IMT)/AAC risk factors through binary logistic regression.

Results: Positive correlations were observed between serum calcium and 25-hydroxyvitamin D (25-[OH]D), haemoglobin, albumin (Alb), prealbumin (PAlb) and serum magnesium. Negative correlations were found with blood urea nitrogen (BUN), serum creatinine (SCr), the estimated glomerular filtration rate (eGFR), serum phosphorus and intact parathyroid hormone (iPTH). Serum phosphorus was positively correlated with BUN, SCr, uric acid, cystatin C (CysC), calcium-phosphate product (Ca×P), iPTH, PAlb and serum magnesium and negatively correlated with eGFR and 25-(OH)D. Parathyroid hormone levels were positively correlated with BUN, SCr, CysC, Ca×P, Alb and PAlb and negatively correlated with eGFR and 25-(OH)D. Logistic regression identified age, sex, and diabetes as independent risk factors for IMT, and age, dialysis vintage and low Alb as risk factors for AAC. Significant differences in AAC were found for sex, dialysis vintage, cholesterol, high-density lipoprotein and serum calcium levels.

Conclusion: Calcium‒phosphorus metabolism plays a role in vascular calcification in CKD, with age, diabetes, dialysis vintage, lipid levels, and low Alb levels contributing to this process.

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慢性肾脏疾病钙磷代谢及其与血管钙化的关系

目的：探讨慢性肾脏病（CKD）患者的骨代谢及其与营养指标的相关性，探讨腹主动脉钙化（AAC）的危险因素。方法：这项横断面研究在2018年5月至2021年5月期间招募了148名CKD 3-5期成人（bb0 - 18岁）（3期：n=13, 4期：n=15, 5期：n=120，包括透析和非透析患者）。参与者符合严格的标准：根据肾脏疾病结局质量倡议指南确诊CKD，营养状况稳定，无吸收不良，未使用维生素K拮抗剂。排除标准包括急性肾损伤、移植受者、恶性肿瘤和甲状腺/甲状旁腺疾病。采用方便抽样，我们通过Pearson分析评估营养/矿物质标志物之间的相关性，并通过二元逻辑回归确定内膜-中膜厚度(IMT)/AAC危险因素。结果：血清钙、25-羟基维生素D （25-[OH]D）、血红蛋白、白蛋白（Alb）、前白蛋白（PAlb）和血清镁呈正相关。血尿素氮（BUN）、血清肌酐（SCr）、肾小球滤过率（eGFR）、血清磷和完整甲状旁腺激素（iPTH）呈负相关。血清磷与BUN、SCr、尿酸、胱抑素C （CysC）、磷酸钙产物（Ca×P）、iPTH、PAlb、血清镁呈正相关，与eGFR、25-(OH)D呈负相关。甲状旁腺激素水平与BUN、SCr、CysC、Ca×P、Alb、PAlb呈正相关，与eGFR、25-(OH)D呈负相关。Logistic回归发现年龄、性别和糖尿病是IMT的独立危险因素，年龄、透析时间和低白蛋白是AAC的危险因素。AAC在性别、透析年份、胆固醇、高密度脂蛋白和血清钙水平上存在显著差异。结论：钙磷代谢在CKD血管钙化中起作用，年龄、糖尿病、透析年龄、脂质水平和低Alb水平参与了这一过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.