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Impact of deteriorated calcium-phosphate homeostasis on amputation-free survival after endovascular revascularization in patients with critical limb ischemia on hemodialysis.
- Source :
-
Vascular medicine (London, England) [Vasc Med] 2016 Apr; Vol. 21 (2), pp. 137-43. Date of Electronic Publication: 2015 Dec 17. - Publication Year :
- 2016
-
Abstract
- Patients on hemodialysis (HD) have abnormalities of calcium-phosphate (CaP) homeostasis and high CaP product contributes to atherosclerosis pathogenesis and adverse events. Patients on HD with critical limb ischemia (CLI) are at risk for major amputation and death because of advanced systemic atherosclerotic disease. The aim of this study was to evaluate the relationship between CaP product and amputation-free survival (AFS) in CLI after endovascular treatment (EVT). We retrospectively analyzed 221 CLI patients on HD. In Kaplan-Meier analysis, AFS was significantly lower in patients with CaP product ⩾ 55 mg(2)/dL(2) compared to those with CaP product <55 mg(2)/dL(2) (54.3% vs 78.5%, p = 0.002). However, neither serum phosphate nor calcium levels were individually associated with AFS. In multivariate analysis, CaP product ⩾ 55 mg(2)/dL(2) was an independent predictor for AFS in CLI patients on HD (hazard ratio, 3.03; 95% confidence interval, 1.78-5.15; p-value < 0.001). We concluded abnormal CaP homeostasis was associated with lower AFS after EVT in CLI patients on HD, and can serve for their risk stratification.<br /> (© The Author(s) 2015.)
- Subjects :
- Aged
Biomarkers blood
Critical Illness
Disease-Free Survival
Female
Homeostasis
Humans
Ischemia complications
Ischemia diagnosis
Ischemia mortality
Kaplan-Meier Estimate
Kidney Diseases blood
Kidney Diseases complications
Kidney Diseases mortality
Limb Salvage
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Amputation, Surgical
Calcium blood
Endovascular Procedures adverse effects
Endovascular Procedures mortality
Ischemia surgery
Kidney Diseases therapy
Phosphates blood
Renal Dialysis adverse effects
Renal Dialysis mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1477-0377
- Volume :
- 21
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Vascular medicine (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 26681436
- Full Text :
- https://doi.org/10.1177/1358863X15619241