The Predictive Value of Serum Fetuin A Level Combined with Red Blood Cell Distribution Width for Cardiovascular Events in Patients with Maintenance Hemodialysis
Objective To investigate the predictive value of serum Fetuin A and red blood cell distribution width(RDW)for adverse cardiovascular events in patients with end-stage renal disease undergoing maintenance hemodialysis(MHD).Methods The clinical data of 203 patients with end-stage renal disease who underwent MHD in our hospital from June,2019 to December,2021 were collected for the analysis.According to the occurrence of adverse cardiovascular events,these patients were grouped into the no-cardiovascular event group(118 cases)and the cardiovascular event group(85 cases).The clinical data from all patients were collected.The level of serum Fetuin A was detected by ELISA.ROC curve was drawn to analyze the predictive value of serum Fetuin A and RDW for cardiovascular events in MHD patients;Logistic regression was used to identify the influencing factors of cardiovascular events in MHD patients.Results There was no significant difference in age,sex,dialysis age,dialysis dehydration ratio,the proportion of diabetes patients,and levels of albumin(ALB),urea nitrogen(BUN),uric acid(UA),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)between patients without cardiovascular events and patients with cardiovascular events(P＞0.05);Compared with the group without cardiovascular events,the proportion of hypertensive patients in the cardiovascular event group,as well as blood phosphorus,blood calcium,parathyroid hormone(iPTH),blood creatinine(sCr),triglycerides(TG),C-reactive protein(CRP),NT proBNP levels,and RDW values were all significantly increased,while hemoglobin(Hb)and Fetin A levels were decreased(P＜0.05);The sensitivity of serum Fetuin A combined with RDW in predicting cardiovascular events in MHD patients was 75.29％,with the specificity of 94.07％,and the area under the curve of 0.897(95％CI 0.847-0.935);Logistic multivariate regression analysis showed that a history of hypertension,elevated blood phosphorus,NT proBNP,TG,and RDW values were risk factors for cardiovascular events in MHD patients,while elevated Fetuin A was a protective factor for cardiovascular events in MHD patients(P＜0.05).Conclusion Increased RDW values and low levels of Fetuin A are independent risk factors for cardiovascular events in MHD patients with end-stage renal disease,which have certain value in predicting cardiovascular events in MHD patients with end-stage renal disease.
NETL
NSTL
万方数据
维普
