Abstract

This study investigated the risk factors of abdominal aortic calcification (AAC) in patients with stage 5 chronic kidney disease (CKD) and the effects of AAC and different dialysis methods on the three-year survival rate of patients with stage 5 CKD. A retrospective cohort study was conducted on stage 5 CKD patients who received dialysis treatment. The general data were collected, and all fasting venous blood samples were harvested before the first dialysis to detect biochemical markers. The AAC was evaluated by lateral abdominal X-ray. The patients were followed up with a cut-off date of March 31, 2022, with all-cause mortality as the endpoint event. A total of 205 patients were included. multivariable Cox regression analysis confirmed that AAC (HR=2.173, 95% CI 1.029-4.588, P=0.042), advanced age (HR=1.061, 95% CI 1.031-1.093, P<0.001), duration of dialysis (HR=1.015, 95% CI 1.007-1.032, P<0.001), diabetes (HR=3.966, 95% CI 2.164-7.269, P<0.001), and hypertension (HR=1.897, 95%CI 1.089-3.303, P=0.024) were independent risk factors for three-year mortality. However, peritoneal dialysis (HR=0.366, 95% CI 0.165-0.812, P=0.013), high albumin (HR=0.882, 95% CI 0.819-0.950, P=0.001), and high hemoglobin (HR=0.969, 95% CI 0.942-0.997, P=0.031) were protective factors for three-year mortality in stage 5 CKD patients. Increased age, long-term dialysis, high level of iPTH, diabetes, and hypertension are closely related to the occurrence of AAC in patients with stage 5 CKD. In addition, AAC is an independent risk factor for all-cause mortality in patients with stage 5 CKD.

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