Abstract:

Abstract:Objective To investigate the prevalence of arterial vascular calcification (VC) in uremic patients undergoing diabetic nephropathy (DN) and  explore its risk factors.   Methods Demographic and clinical data were collected in the patients latest diagnosed as uremia and not received dialysis treatment. The uremic patients were divided into DN group and non-diabetic nephropathy (NDN)group. And 20 healthy subjects  were chosen as control group from the Physical Examination Room. The patients’ sex and ages were similar in the 3 groups.VC was semi-quantitatively evaluated by plain radiographic films from abdomen，pelvis and hands．The clinical and laboratorial parameters related to VC  were detected and analyzed.  Results ①The present study included 20（51.28%） DN uremic patients and 19(48.72%) NDN uremic patients．The average diabetic duration in the DN patients was (8.11±7.39) years. ②Among the 39 uremic patients，VC was found on radiographic films in 29 cases (74.36％)，including 23 cases (58.97%) with the con-score 1-3 and 6 cases (15.38%)with 3-6 scores. And VC was not detected in control group.Bone density analysis showed that osteopenia occupied 14 cases (35.90%) in all and the T-score was －0.81±0.87. ③Linear correlation analysis revealed that VC was correlated with serum calcium and phosphate（r=0.026,P<0.05；r=－0.639,P<0.05）,and uncorrelated with bone density（P>0.05）. VC score was significantly correlated with the diabetic duration（r=0.790,P<0.001）. Logistic regression revealed that the diabetes duration was the independent risk factors （P<0.05）for VC．The reflections of serum calcium and phosphate were rejected. ④The prevalence of VC in DN gourp (95.0%) was higher than that  in NDN group（42.1%,P<0.05）．And the VC score in DN group （3.18±1.77）was higher than that in NDN group （1.56±0.97,P<0.05).Conclusion There is a higher VC prevalence rate and more VC severity in DN uremic patients than in NDN patients. Diabetes duration is an independent risk factor for VC．Preventing from the high serum glucose maybe plays an effective role in controlling the VC  in diabetic nephropathy patients in uremic stage.

Key words: vascular calcification;diabetic nephropathy;uremia