Occurrence and influencing factors of cardiovascular diseases in uremic patients after combined blood purification therapy

Objective To analyze the incidence and influencing factors of cardiovascular disease （CVD） in uremia patients after combined blood purification therapy.Methods Clinical data of uremia patients admitted to Putuo People's Hospital， Tongji University from January 1， 2021 to January 31， 2023 were retrospectively analyzed. All patients received combined blood purification treatment （hemodialysis + hemoperfusion + hemodialysis filtration）. They were divided into the CVD group and non-CVD group based on the presence or absence of CVD at 12 months of treatment. The general demographic data and clinical data of the two groups were compared. Logistic regression model was used to analyze the influencing factors of CVD occurrence after combined blood purification， and Spearman correlation analysis was used to analyze the correlation between each factor and CVD occurrence.Results A total of 122 uremia patients were included in the study， of which 20 had CVD， accounting for 16.39%， and the remaining 102 （83.61%） without CVD were included in the non-CVD group. Logistic regression analysis showed age， treatment time， CVD history， soluble Fas ligand （sFasL） expression in serum and soluble cardiac troponin T （cTnT） before treatment， human advanced oxidation protein products （AOPP）， serum ferritin （SF）， serum hemoglobin （Hb）， parathyroid hormone （PTH） and calcium-phosphorus product were all factors affecting the development of CVD after combined blood purification. OR values were 1.270， 1.938， 13.800， 46.984， 1.270， 8.522， 2.145， 1.495， 1.733， and 1.528， respectively. Age， treatment time， CVD history， serum sFasL expression， average cTnT， AOPP， PTH， calcium and phosphorus product before treatment were positively correlated with CVD occurrence （r=0.471， 0.643， 0.589， 0.485， 0.647， 0.499， 0.528， and 0.492， respectively； all P<0.05）. SF and Hb were negatively correlated with CVD （r=-0.505， and -0.478， respectively； both P<0.05）.Conclusion CVD occurs in some uremia patients after combined blood purification treatment. Age， treatment time， CVD history， serum sFasL expression， average cTnT， AOPP， SF， Hb， PTH and calcium-phosphorus product before treatment are the influencing factors for cardiovascular prognosis， which are related to the occurrence of CVD. It is necessary to pay close attention to patients with old age， long treatment time and history of CVD， and strengthen the detection of serum sFasL， cTnT， AOPP， SF， Hb， PTH and calcium and phosphorus product， which can provide theoretical basis for clinical diagnosis and prevention of CVD， and thus improve the cardiovascular prognosis of patients.