Relationship between intact parathyroid hormone,fetal globulin A,serum creatinine/hemoglobin ratio and disorder of calcium and phosphorus metabolism in maintenance hemodialysis patients with chronic kidney disease and their predictive values for carotid artery calcification

Objective To explore the relationship between intact parathyroid hormone(iPTH),fetal globulin A(FA),serum creatinine/hemoglobin ratio(Scr/Hb)and calcium and phosphorus metabolism disorder in chronic renal failure patients with chronic kidney disease(CKD)on maintenance hemodialysis(MHD)and examine the predictive value of each parameter for carotid atherosclerosis.Methods From July 2014 to July 2020,113 CKD patients on MHD were recruited and divided into two groups of sclerosis(n=30)and non-sclerosis(n=83). The baseline levels of iPTH,FA and Scr/Hb of two groups were recorded. The related influencing factors of carotid atherosclerosis,parameters of calcium and phosphorus metabolism and their correlations were examined.Results Baseline phosphorus,iPTH and Scr/Hb in sclerosis group were higher than those in non-sclerosis group(1.89±0.42)mmol/L、305.26(152.63,608.19)μg/L、7.16±2.19 vs(1.30±0.36)mmol/L、238.47(118.05,506.11)μg/L、4.38±1.38,P<0.001,FA was lower than that of non-sclerosis group(74.62±20.61)mg/L vs(95.33±25.80)mg/L,P<0.05;mean values of iPTH,FA and Scr/Hb were selected as boundary,<mean value was low level, ≥ mean value high level. High levels of iPTH and Scr/Hb were higher than those with low levels(1.60±0.39)mmol/L vs(1.18±0.33)mmol/L,(1.71±0.55)mmol/L vs(0.97±0.31)mmol/Land those with high levels of FA lower than those with low levels(1.25±0.34)mmol/L vs(1.72±0.40)mmol/L,P<0.05;iPTH,Scr/Hb and phosphorus were positively correlated while FA was negatively correlated with phosphorus(P<0.05);iPTH,FA,Scr/Hb were still associated with IMT(P<0.05);the area under the curve(AUC)of iPTH,FA and Scr/Hb for predicting carotid atherosclerosis were 0.742,0.776 and 0.790respectively. It was the largest at 0.918 for combined predicting. The optimal predictive sensitivity and specificity were 93.33% and 85.54% respectively.Conclusion iPTH,FA and Scr/Hb are closely correlated with disorder of calcium and phosphorus metabolism in chronic renal failure patients with CKD on MHD. These parameters offer high application values in predicting carotid atherosclerosis.