Abstract:

ABSTRACT  Objective: To investigate the prevalence and the risk factors of cardiovascular diseases (CVD) in IgA nephropathy (IgAN) and diabetic nephropathy (DN) patients with CKD stage 2～5. Methodology: One hundred eighty one patients with biopsy-proven IgAN and one hundred ninety nine patients with biopsy-proven DN, who were hospitalized or followed in our Nephrology Department, were surveyed by collecting the history and laboratory data. Results: The prevalence of CVD in IgAN patients with CKD stage2～5 were 8.7%, 7.7%, 17.2% and 44.4% respectively, while the prevalence of CVD in DN patients with CKD stage 2～5 were 29.6%, 40.0%, 45.2% and 72.7% respectively. The prevalence of CVD in the each CKD stage patients with DN were significantly increased compared with that in the patients with IgAN (CKD stage 2 29.6% vs 8.7%, P<0.01, CKD stage 3 40.0% vs7.7%, P<0.01, CKD stage 4 45.2% vs 17.2%, P<0.05, CKD stage 5 72.7% vs 44.4%, P<0.05). The total prevalence of CAD and LVH in the patients with DN were markedly elevated as compared with that in the patients with IgAN, and the difference in CAD between two diseases was the most significant (CAD 16.1% vs 0.6%，P<0.01，LVH 33.2% vs 14.7%，P<0.01). The prevalence of CVD in the patients of both diseases with CKD stage 5 was remarkably higher than that in the patients with CKD stage 2～4. In the patients with IgAN, the incidence of hypertension, the levels of SCr and serum phosphate in patients with CVD were significantly elevated and the level of Hb was decreased as compared with that in the patients without CVD. In the patients with DN, the incidence of smoking history, hypertension, the levels of SCr and TC in patients with CVD were significantly increased as compared with that in the patients without CVD. Logistic regression analysis showed that SCr and Hb were the risk factors for LVH in the patients with IgAN (OR values were 1.22，P<0.05 and 0.67，P<0.01), SCr and BMI were the risk factors for LVH in the patients with DN (OR values were 1.77，P<0.01；1.36，P<0.05), and smoking history, SCr and LDL were the risk factors for CAD in the patients with DN (OR values were 2.96, P<0.05; 1.45, P<0.01; 6.93, P<0.05 respectively). Conclusions: The prevalence of CVD in the each CKD stage patients with DN was higher than that in patients with IgAN, and LVH was the commonest manifestation of CVD in the patients with both diseases. The prevalence of CAD and LVH in the patients with DN was higher than that in the patients with IgAN, which suggest the correlation with higher CVD mortality in the patients with DN. The prevalence of CVD in the patients of both diseases with CKD stage 5 was remarkably increasing, indicating the early intervention in CKD patients is necessary.

Key words: IgA nephropathy , diabetic nephropathy , cardiovascular disease , prevalence , risk factors