Document Detail


Progression of aortic calcification is associated with disorders of mineral metabolism and mortality in chronic dialysis patients.
MedLine Citation:
PMID:  20880929     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have shown that simple imaging methods may be useful for detection of vascular calcifications in dialysis patients. Based on annual, plain chest X-rays during follow-up on dialysis, we studied the associations of mineral metabolism with the presence and progression of aortic calcification. In addition, we assessed the impact of aortic calcification on mortality.
METHODS: Three hundred and eighty-four patients who started haemodialysis or peritoneal dialysis between 1997 and 2007 were included (age 61 ± 15 years, 64% male, 61% haemodialysis). Annual chest X-rays were screened for calcification in the aortic arch, and patients were categorized as having no, moderate or severe calcification. Progression was defined as an increase in calcification category during follow-up on dialysis.
RESULTS: At baseline, 96 (25%) patients had severe, 205 (53%) patients had moderate and 83 (22%) patients had no aortic calcification. For 237 of the 288 patients with no or moderate calcifications at baseline, X-rays were available for follow-up. During follow-up (mean 2.3 years), aortic calcification progressed in 71 patients (30%). We found that baseline plasma calcium > 9.5 mg/dL and iPTH > 300 pg/mL were associated with progression [odds ratios of 3.1, 95% confidence interval (1.2-8.2) and 4.4 (1.4-14.1), respectively]. Progression of aortic calcification was significantly associated with increased risk of all-cause mortality (hazard ratio: 1.9; 95% CI: 1.2-3.1) and cardiovascular mortality (hazard ratio: 2.7; 95% CI: 1.3-5.6).
CONCLUSIONS: Aortic calcification progressed in almost a third of the patients during dialysis. Hypercalcaemia and hyperparathyroidism were associated with an increased risk of progression. Progression of aortic calcification was significantly related to an increased mortality risk.
Authors:
Marlies Noordzij; Ellen M Cranenburg; Lyda F Engelsman; Marc M Hermans; Elisabeth W Boeschoten; Vincent M Brandenburg; Willem Jan W Bos; Jeroen P Kooman; Friedo W Dekker; Markus Ketteler; Leon J Schurgers; Raymond T Krediet; Johanna C Korevaar;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-29
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  26     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1662-9     Citation Subset:  IM    
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.noordzij@amc.uva.nl
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Investigator
Investigator/Affiliation:
A J Apperloo / ; J A Bijlsma / ; M Boekhout / ; W H Boer / ; P J M van der Boog / ; M van Buren / ; F Th de Charro / ; C J Doorenbos / ; M A van den Dorpel / ; A van Es / ; W J Fagel / ; G W Feith / ; C W H de Fijter / ; L A M Frenken / ; W Grave / ; J A C A van Geelen / ; P G G Gerlag / ; J P M C Gorgels / ; R M Huisman / ; K J Jager / ; K Jie / ; W A H Koning-Mulder / ; M I Koolen / ; T K Kremer Hovinga / ; A T J Lavrijssen / ; A J Luik / ; K J Parlevliet / ; M H M Raasveld / ; F M van der Sande / ; M J M Schonck / ; M M J Schuurmans / ; C E H Siegert / ; C A Stegeman / ; P Stevens / ; J G P Thijssen / ; R M Valentijn / ; G H Vastenburg / ; C A Verburgh / ; V M C Verstappen / ; H H Vincent / ; P F Vos /
Comments/Corrections
Comment In:
Nephrol Dial Transplant. 2011 May;26(5):1747-8   [PMID:  21382995 ]

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