Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Factors Affecting Coronary Arterial Calcification in Patients with Chronic Kidney Disease Who Did Not Undergo Treatment with Dialysis

투석을 시행 받지 않은 만성 신질환 환자에서 관상동맥 석회화에 영향을 미치는 인자

  • Kim, Kunsu (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Goeun (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Yongkyun (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Ki, So Yeon (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Bae, Eun Hui (Department of Nephrology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Soo Wan (Department of Nephrology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Yun-Hyeon (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School)
  • 김건수 (전남대학교 의과대학 전남대학교병원 영상의학과) ;
  • 김고은 (전남대학교 의과대학 전남대학교병원 영상의학과) ;
  • 김용균 (전남대학교 의과대학 전남대학교병원 영상의학과) ;
  • 기소연 (전남대학교 의과대학 전남대학교병원 영상의학과) ;
  • 배은희 (전남대학교 의과대학 전남대학교병원 신장내과) ;
  • 김수완 (전남대학교 의과대학 전남대학교병원 신장내과) ;
  • 김윤현 (전남대학교 의과대학 전남대학교병원 영상의학과)
  • Received : 2017.11.10
  • Accepted : 2018.01.03
  • Published : 2018.02.01
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Abstract

Purpose: To investigate risk factors of coronary arterial calcification in chronic kidney disease (CKD) patients who did not undergo hemodialysis or peritoneal dialysis. Materials and Methods: We enrolled 83 patients of normal renal function (Group I) and 112 patients of CKD [Group II (CKD stage 1-2) and Group III (CKD stage 3-5)], who were assessed coronary artery calcium score (CACS) with cardiac CT. CACS between the groups were compared. Risk factors for coronary artery calcification in patients with CKD including diabetes, hypertension, and smoking were identified as relevant to CACS using logistic regression analysis. Serologic data of electrolytes were analyzed to evaluate effect for coronary calcification in patients with CKD. Results: Group III showed significant increment of CACS compared to Group I at the CACS level over 400 [odds ratio (OR) = 7.581, p = 0.01]. The OR were decreased in non-diabetic patients group, increased in non-hypertensive patients group, no significant differences in non-current smoker group. Serum phosphorous level was the only factor which showed significant effect for increased CACS (OR of 2.649, p = 0.02). Conclusion: In CKD patients, higher stage of CKD was associated with increased CACS. Diabetes mellitus and increased serum phosphorous level would be considered as factors influencing coronary arterial calcification in CKD patients.

목적: 투석을 시행 받지 않은 만성 신질환(chronic kidney disease; 이하 CKD) 환자에서 관상동맥 석회화에 영향을 미치는 인자에 대하여 알아보았다. 대상과 방법: 투석을 시행 받지 않은 CKD 환자 중 심장 CT를 이용하여 관상동맥 칼슘 점수(coronary artery calcium score; 이하 CACS)를 측정한 112명과, 동일한 검사를 시행한 정상 신기능군 83명을 대상으로 하였다. 정상 신기능군을 Group I으로, CKD 환자들은 병기에 따라 Group II (1~2기 환자)와 Group III (3~5기 환자)로 나누고 이들 군 간의 CACS를 비교하였다. 또한 CKD 환자군에서 당뇨, 고혈압, 흡연 등이 CACS에 미치는 영향과, 이들의 혈액검사에서 CACS에 영향을 미치는 인자를 분석하였다. 결과: Group I에 비하여 Group III의 환자군에서 CACS 400 이상의 빈도가 유의하게 높았다[odd ratios (이하 OR) = 7.581, p = 0.01]. CKD 환자군에서 당뇨가 CACS의 증가에 유의한 결과를 보였으며, 혈청 인의 농도가 CACS 400 이상에서 유의한 관련성을 보였다(OR = 2.649, p = 0.02). 결론: CKD의 병기가 높을수록 CACS가 의의 있게 높았으며, 이들 환자에서 당뇨와 혈청 인의 농도가 관상동맥 석회화에 유의한 영향을 주었다.

Keywords

References

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