Predictive value of red cell distribution width in thoracic aorta calcification in patients with different dialysis modalities

doi:10.3969/j.issn.1004-583X.2024.02.009

Abstract

Abstract:

Objective To analyze the risk factors of thoracic aortic calcification (TAC) in maintenance dialysis patients, and to explore the predictive value of red cell distribution width (RDW) in TAC of patients with hemodialysis and peritoneal dialysis. Methods Clinical data of 190 patients on long-term maintenance dialysis in the Second Affiliated Hospital of Kunming Medical University from January 2022 to June 2022 were collected. According to the finding of TAC on chest X-ray scans, patients were divided into calcification group (n=48) and non-calcification group (n=142). Risk factors of TAC in dialysis patients were analyzed by binary logistic regression analysis. The receiver operating characteristic (ROC) curve was applied to analyze the predictive value of RDW in TAC of patients with different dialysis modalities. Results The proportion of TAC was 25.3%. The RDW was significantly higher in the calcification group than that of the non-calcification group (P<0.01). Multivariate Logistic regression analysis showed that RDW (OR=1.541, 95%CI: 1.145, 2.074, P=0.004), age (OR=1.041, 95%CI: 1.008, 1.075, P=0.014), duration of dialysis (OR=1.016, 95%CI: 1.002, 1.031, P=0.025) and serum phosphate (OR=2.172, 95%CI: 1.109, 4.253, P=0.024) were independent risk factors for TAC in dialysis patients. The area under the curve (AUC) of RDW in predicting TAC in hemodialysis patients was larger than that in peritoneal dialysis patients (0.719 vs 0.661). Conclusion RDW is an independent risk factor for TAC in dialysis patients, and it has a better predictive value in hemodialysis patients than that in peritoneal dialysis patients.

Key words: erythrocyte indices, dialysis, aorta, thoracic, predictive value

CLC Number:

R446.113

Zhang Feng, Jiang Hongying, Yang Jiao, Li Ruihe, He Ting, Li Meng. Predictive value of red cell distribution width in thoracic aorta calcification in patients with different dialysis modalities[J]. Clinical Focus, 2024, 39(2): 144-148.

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https://huicui.hebmu.edu.cn/EN/Y2024/V39/I2/144

Figures/Tables 5

References 26

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项目	总体(n=190)	非钙化组(n=142)	钙化组(n=48)	t/χ²/Z值	P值
性别[例(%)]
男女	118(62.1) 72(37.9)	84(59.2) 58(40.8)	34(70.8) 14(29.2)	2.079	0.149
透析方式[例(%)]	190(100)	142(74.7)	48(25.3)	0.169	0.681
血液透析	106(55.8)	78(54.9)	28(58.3)
腹膜透析	84(44.2)	64(45.1)	20(41.7)
年龄(岁)	56.8±13.9	55.1±14.2	62.0±11.9	-3.023	0.003
透析龄(月)	46.1±26.7	44.1±24.7	52.0±31.3	-1.780	0.077
体重(kg)	60.17±11.99	59.413±12.154	62.417±11.297	-1.506	0.134
身高(cm)	164.0(157,169)	163(156,168)	165(158,170)	-1.308	0.191
原发病[例(%)]	190(100)	142(74.7)	48(25.3)	5.512	0.598
原发性肾小球疾病	47(24.7)	37(26.1)	10(20.8)
糖尿病肾病	61(32.1)	41(28.9)	20(41.7)
高血压肾病	42(22.1)	33(23.2)	9(18.8)
其他原因肾病	40(21.1)	31(21.8)	9(18.8)
合并糖尿病[例(%)]	61(32.1)	41(67.2)	20(32.8)	2.694	0.101
合并高血压[例(%)]	161(84.7)	124(77.0)	37(23.0)	2.909	0.088
合并冠心病[例(%)]	30(15.8)	20(66.7)	10(33.3)	1.229	0.268
合并脑血管病[例(%)]	17(8.9)	12(70.6)	5(29.4)	0.014	0.904
红细胞计数(×10¹²/L)	3.52±0.74	3.49±0.75	3.59±0.73	-0.767	0.444
血红蛋白(g/L)	104.51±21.90	104.40±22.48	104.71±20.37	-0.074	0.941
红细胞平均体积(fl)	91.35(86.48,95.73)	91.35(86.48,95.73)	90.35(86.08,95.80)	-0.874	0.382
红细胞血红蛋白平均含量(pg)	29.95(28.30,31.43)	30.15(28.60,31.50)	29.45(27.20,31.28)	-1.909	0.056
红细胞血红蛋白平均浓度(g/L)	327.00(319.00,334.00)	328.50(319.75,336.00)	323.50(318.25,329.75)	-2.490	0.013
RDW(%)	14.11(13.51,15.18)	13.95(13.40,14.78)	14.75(14.00,16.30)	-4.007	0.000
白蛋白(g/L)	38.00(30.15, 41.60)	37.75(29.23,42.30)	38.35(30.43,40.10)	-0.442	0.659
前白蛋白(mg/L)	300.79±87.81	309.18±89.02	276.25±81.15	0.704	0.025
血尿素(mmol/L)	19.79±7.09	19.45±6.76	20.75±8.10	-0.998	0.322
血肌酐(μmol/L)	946.33±313.40	948.13±324.54	939.04±287.27	0.186	0.853
血尿酸(mmol/L)	409.00(358.00,486.70)	408.00(357.30, 479.00)	407.00(357.00,491.80)	-0.252	0.801
总胆固醇(mmol/L)	4.04(3.37,4.85)	4.04(3.29,4.86)	4.02(3.42,4.75)	-0.203	0.839
甘油三酯(mmol/L)	1.57(1.07,2.45)	1.57(1.04,2.33)	1.55(1.06,2.92)	-0.984	0.325
高密度脂蛋白胆固醇(mmol/L)	0.96(0.79,1.18)	0.99(0.81,1.19)	0.85(0.73,1.17)	-1.465	0.143
低密度脂蛋白胆固醇(mmol/L)	2.44(1.91,2.99)	2.49(1.86,3.04)	2.24(1.97,2.82)	-0.320	0.749
血糖(mmol/L)	4.96(4.34,6.16)	4.88(4.26,5.87)	5.65(4.58,7.06)	-2.505	0.012
血钙(mmol/L)	2.22(2.01,2.33)	2.23(2.01,2.35)	2.17(2.00,2.33)	-0.761	0.447
血磷(mmol/L)	1.68(1.358,2.03)	1.68(1.29,2.01)	1.91(1.35,2.73)	-1.296	0.195
甲状旁腺激素(pg/ml)	323.34(173.46,715.21)	298.85(162.82,696.22)	372.53(210.13,807.68)	-1.303	0.193

项目	总体(n=190)	非钙化组(n=142)	钙化组(n=48)	t/χ²/Z值	P值
性别[例(%)]
男女	118(62.1) 72(37.9)	84(59.2) 58(40.8)	34(70.8) 14(29.2)	2.079	0.149
透析方式[例(%)]	190(100)	142(74.7)	48(25.3)	0.169	0.681
血液透析	106(55.8)	78(54.9)	28(58.3)
腹膜透析	84(44.2)	64(45.1)	20(41.7)
年龄(岁)	56.8±13.9	55.1±14.2	62.0±11.9	-3.023	0.003
透析龄(月)	46.1±26.7	44.1±24.7	52.0±31.3	-1.780	0.077
体重(kg)	60.17±11.99	59.413±12.154	62.417±11.297	-1.506	0.134
身高(cm)	164.0(157,169)	163(156,168)	165(158,170)	-1.308	0.191
原发病[例(%)]	190(100)	142(74.7)	48(25.3)	5.512	0.598
原发性肾小球疾病	47(24.7)	37(26.1)	10(20.8)
糖尿病肾病	61(32.1)	41(28.9)	20(41.7)
高血压肾病	42(22.1)	33(23.2)	9(18.8)
其他原因肾病	40(21.1)	31(21.8)	9(18.8)
合并糖尿病[例(%)]	61(32.1)	41(67.2)	20(32.8)	2.694	0.101
合并高血压[例(%)]	161(84.7)	124(77.0)	37(23.0)	2.909	0.088
合并冠心病[例(%)]	30(15.8)	20(66.7)	10(33.3)	1.229	0.268
合并脑血管病[例(%)]	17(8.9)	12(70.6)	5(29.4)	0.014	0.904
红细胞计数(×10¹²/L)	3.52±0.74	3.49±0.75	3.59±0.73	-0.767	0.444
血红蛋白(g/L)	104.51±21.90	104.40±22.48	104.71±20.37	-0.074	0.941
红细胞平均体积(fl)	91.35(86.48,95.73)	91.35(86.48,95.73)	90.35(86.08,95.80)	-0.874	0.382
红细胞血红蛋白平均含量(pg)	29.95(28.30,31.43)	30.15(28.60,31.50)	29.45(27.20,31.28)	-1.909	0.056
红细胞血红蛋白平均浓度(g/L)	327.00(319.00,334.00)	328.50(319.75,336.00)	323.50(318.25,329.75)	-2.490	0.013
RDW(%)	14.11(13.51,15.18)	13.95(13.40,14.78)	14.75(14.00,16.30)	-4.007	0.000
白蛋白(g/L)	38.00(30.15, 41.60)	37.75(29.23,42.30)	38.35(30.43,40.10)	-0.442	0.659
前白蛋白(mg/L)	300.79±87.81	309.18±89.02	276.25±81.15	0.704	0.025
血尿素(mmol/L)	19.79±7.09	19.45±6.76	20.75±8.10	-0.998	0.322
血肌酐(μmol/L)	946.33±313.40	948.13±324.54	939.04±287.27	0.186	0.853
血尿酸(mmol/L)	409.00(358.00,486.70)	408.00(357.30, 479.00)	407.00(357.00,491.80)	-0.252	0.801
总胆固醇(mmol/L)	4.04(3.37,4.85)	4.04(3.29,4.86)	4.02(3.42,4.75)	-0.203	0.839
甘油三酯(mmol/L)	1.57(1.07,2.45)	1.57(1.04,2.33)	1.55(1.06,2.92)	-0.984	0.325
高密度脂蛋白胆固醇(mmol/L)	0.96(0.79,1.18)	0.99(0.81,1.19)	0.85(0.73,1.17)	-1.465	0.143
低密度脂蛋白胆固醇(mmol/L)	2.44(1.91,2.99)	2.49(1.86,3.04)	2.24(1.97,2.82)	-0.320	0.749
血糖(mmol/L)	4.96(4.34,6.16)	4.88(4.26,5.87)	5.65(4.58,7.06)	-2.505	0.012
血钙(mmol/L)	2.22(2.01,2.33)	2.23(2.01,2.35)	2.17(2.00,2.33)	-0.761	0.447
血磷(mmol/L)	1.68(1.358,2.03)	1.68(1.29,2.01)	1.91(1.35,2.73)	-1.296	0.195
甲状旁腺激素(pg/ml)	323.34(173.46,715.21)	298.85(162.82,696.22)	372.53(210.13,807.68)	-1.303	0.193

因素	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
因素	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
年龄	0.038	0.013	8.398	0.004	1.039	1.012	1.066
透析龄	0.011	0.006	3.055	0.080	1.011	0.999	1.023
身高	0.031	0.023	1.710	0.188	1.032	0.985	1.080
体重	0.021	0.014	2.218	0.136	1.021	0.994	1.049
合并糖尿病	0.565	0.346	2.661	0.103	1.760	0.892	3.470
合并高血压	-0.717	0.426	2.831	0.092	0.488	0.212	1.126
合并冠心病	0.473	0.430	1.214	0.271	1.605	0.692	3.725
合并脑血管病	0.231	0.561	0.170	0.680	1.260	0.420	3.780
RDW	0.513	0.131	15.360	<0.01	1.670	1.292	2.158
前白蛋白	-0.004	0.002	4.913	0.027	0.996	0.992	0.999
总胆固醇	0.017	0.144	0.013	0.908	1.017	0.767	1.347
甘油三酯	0.189	0.101	3.462	0.063	1.208	0.990	1.474
低密度脂蛋白胆固醇	-0.047	0.193	0.059	0.807	0.954	0.654	1.392
血糖	0.140	0.057	5.957	0.015	1.150	1.028	1.286
血钙	-0.818	0.655	1.559	0.212	0.441	0.122	1.593
血磷	0.497	0.270	3.391	0.066	1.645	0.969	2.793
甲状旁腺激素	0.000	0.000	0.066	0.797	1.000	1.000	11.001

因素	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
因素	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
年龄	0.038	0.013	8.398	0.004	1.039	1.012	1.066
透析龄	0.011	0.006	3.055	0.080	1.011	0.999	1.023
身高	0.031	0.023	1.710	0.188	1.032	0.985	1.080
体重	0.021	0.014	2.218	0.136	1.021	0.994	1.049
合并糖尿病	0.565	0.346	2.661	0.103	1.760	0.892	3.470
合并高血压	-0.717	0.426	2.831	0.092	0.488	0.212	1.126
合并冠心病	0.473	0.430	1.214	0.271	1.605	0.692	3.725
合并脑血管病	0.231	0.561	0.170	0.680	1.260	0.420	3.780
RDW	0.513	0.131	15.360	<0.01	1.670	1.292	2.158
前白蛋白	-0.004	0.002	4.913	0.027	0.996	0.992	0.999
总胆固醇	0.017	0.144	0.013	0.908	1.017	0.767	1.347
甘油三酯	0.189	0.101	3.462	0.063	1.208	0.990	1.474
低密度脂蛋白胆固醇	-0.047	0.193	0.059	0.807	0.954	0.654	1.392
血糖	0.140	0.057	5.957	0.015	1.150	1.028	1.286
血钙	-0.818	0.655	1.559	0.212	0.441	0.122	1.593
血磷	0.497	0.270	3.391	0.066	1.645	0.969	2.793
甲状旁腺激素	0.000	0.000	0.066	0.797	1.000	1.000	11.001

因素	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
因素	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
RDW	0.476	0.432	8.122	0.004	1.541	1.145	2.074
年龄	0.040	0.016	6.608	0.014	1.041	1.008	1.075
透析龄	0.015	0.007	4.995	0.025	1.016	1.002	1.031
血磷	0.819	0.776	5.119	0.024	2.172	1.109	4.253