Analysis of coronary artery calcification and its risk factors in patients with stage 5 chronic kidney disease

Zhang Xiaocui; Zhang Haowen; Zuo Hongwei; Mou Aihua; Mao Jie; Pang Yuhong

doi:10.3969/j.issn.1674-3245.2025.01.017

Abstract：Objective To examine the coronary artery calcification and identify its risk factors among patients with stage 5 chronic kidney disease(CKD)undergoing maintenance hemodialysis.Methods The clinical data of 307 patients with stage 5 chronic kidney disease(CKD)who were hospitalized in the department were retrospectively analyzed from January 2020 to December 2021,including the basic data of patients,whether they were complicated with hypertension,diabetes mellitus,smoking and dialysis,laboratory examination indexes and chest CT to evaluate whether there was coronary artery calcification.Initial univariate analysis was conducted on all independent variables,and those found to be significant were subsequently incorporated into a multivariate logistic regression model to assess the risk factors associated with coronary artery calcification in stage 5 CKD patients.Then we established a nomogram prediction model of coronary artery calcification in patients with stage 5 CKD.Receiver operating characteristic curve(ROC)and Hosmer and Lemeshow test were used to verify and evaluate the established nomogram model.Results There were statistical differences in age,dialysis,diabetes mellitus,smoking,serum calcium,serum phosphorus,alkaline phosphatase,serum magnesium between patients with calcification and patients without calcification(χ2/t=34.532,18.091,17.976,5.709,19.326,P<0.05).Age,dialysis,diabetes mellitus,smoking,serum calcium,serum phosphorus and alkaline phosphatase were risk factors for coronary artery calcification(P<0.05),and serum magnesium was a protective factor(P<0.05).A nomogram prediction model for coronary artery calcification in patients with stage 5 CKD was established according to the above eight risk factors,and the AUC value of the model was 0.869(95%CI=0.829～0.908)verified by ROC,suggesting that the model had good discrimination.Hosmer and Lemeshow test demonstrated that the deviation between the predicted value and the actual observed value was not statistically significant(χ2=6.18,P=0.627),suggesting that the model was well calibrated.Conclusion Age,dialysis,diabetes mellitus,smoking,serum calcium,serum phosphorus,alkaline phosphatase and other factors are all risk factors for coronary calcification in patients with stage 5 CKD.It is necessary to carry out clinical intervention according to the above factors to reduce the risk of coronary calcification in patients.The nomogram model established in this study can effectively predict the occurrence of coronary calcification in patients with stage 5 CKD,provide help for clinical diagnosis and treatment,and improve the prognosis of patients with stage 5 CKD.