原发性慢性肾脏病患者脂质代谢及凝血功能变化及临床意义

doi:10.3969/j.issn.1006-6233.2023.02.026

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Abstract Objective: To study the changes and clinical significance of lipid metabolism and coagulation function in patients with primary chronic kidney disease (CKD). Methods: 120 patients with CKD admitted to the hospital from January 2020 to April 2022 were selected as samples for a cross-sectional study. After admission, blood lipid metabolism indicators such as blood urea nitrogen (BUN), serum creatinine (Scr), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1) and apoB as well as coagulation function indicators of fibrinogen (FIB), D-dimer (D-D), activated partial thromboplastin time (APTT), fibrinogen degradation product (FDP), thrombin time (TT), prothrombin time (PT) and international normalized ratio (INR) were measured. The patients were divided into the CVD group and the control group according to whether CVD occurred or not. The indicators of the two groups were compared and the Logistic regression model was established, and then the predictive value of the model on CVD risk was analyzed by calibration. Results: 34 cases (28.33%) of 120 patients with CKD were complicated with CVD. The proportion of patients with CKD stage 5 and levels of BUN, Scr, TC, LDL-C, and FIB in the CVD group were higher than those in the control group while the level of HDL-C was lower than that in the control group (P<0.05). CKD staging was negatively correlated with lipid metabolism indicators of HDL-C, apoA1, and apoB (P<0.05), and was positively correlated with coagulation function indicators of PT, FIB, D-D, and INR (P<0.05). Binary Logistic regression analysis showed that TC, HDL-C, and FIB were closely related to CVD in patients with CKD (P<0.05), and the predictive model for the risk of CVD in patients with CKD was shown as logit(P)= -2.864+ 0.571× (TC) -2.748× (HDL-C) +0.620× (FIB). The AUC, sensitivity, and specificity of predicting CVD in patients with CKD were 0.807 (95%CI: 0.725~0.873), 82.35%, and 69.77%. Conclusion: The lipid metabolism and coagulation function of patients with primary CKD are abnormal, and there is a significant correlation with CKD staging. The logistic regression model established based on TC, HDL-C, FIB and other indicators have a good reference value for predicting the risk of CVD in patients with CKD.

Key words： Chronic kidney disease Primary glomerulonephritis Cardiovascular disease Lipid metabolism Coagulation function

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	Articles by authors
	LUO Jun
	GENG Keming
	ZHANG Yunhui
	et al

Cite this article:

LUO Jun,GENG Keming,ZHANG Yunhui, et al. Changes in Lipid Metabolism and Coagulation Function in Patients with Primary Chronic Kidney Disease and Their Clinical Significance[J]. HeBei Med, 2023, 29(2): 311-317.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.02.026 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I2/311

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