Lei Ran, Xiaoxi Wu, Li Guo, Yapu Zhang, Lei Wang, Tingting Cai, Youlan Gong
{"title":"慢性肾脏疾病钙磷代谢及其与血管钙化的关系","authors":"Lei Ran, Xiaoxi Wu, Li Guo, Yapu Zhang, Lei Wang, Tingting Cai, Youlan Gong","doi":"10.1159/000548408","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-20"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Calcium‒Phosphorus Metabolism in Chronic Kidney Disease and Its Relationship with Vascular Calcification.\",\"authors\":\"Lei Ran, Xiaoxi Wu, Li Guo, Yapu Zhang, Lei Wang, Tingting Cai, Youlan Gong\",\"doi\":\"10.1159/000548408\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":17813,\"journal\":{\"name\":\"Kidney & blood pressure research\",\"volume\":\" \",\"pages\":\"1-20\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kidney & blood pressure research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000548408\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney & blood pressure research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548408","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Calcium‒Phosphorus Metabolism in Chronic Kidney Disease and Its Relationship with Vascular Calcification.
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.
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.
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