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Vascular Calcification Progression Modulates the Risk Associated with Vascular Calcification Burden in Incident to Dialysis Patients
- Source :
- Cells, Volume 10, Issue 5, Cells, Vol 10, Iss 1091, p 1091 (2021)
- Publication Year :
- 2021
- Publisher :
- NLM (Medline), 2021.
-
Abstract
- Background: It is estimated that chronic kidney disease (CKD) accounts globally for 5 to 10 million deaths annually, mainly due to cardiovascular (CV) diseases. Traditional as well as non-traditional CV risk factors such as vascular calcification are believed to drive this disproportionate risk burden. We aimed to investigate the association of coronary artery calcification (CAC) progression with all-cause mortality in patients new to hemodialysis (HD). Methods: Post hoc analysis of the Independent study (NCT00710788). At study inception and after 12 months of follow-up, 414 patients underwent computed tomography imaging for quantification of CAC via the Agatston methods. The square root method was used to assess CAC progression (CACP), and survival analyses were used to test its association with mortality. Results: Over a median follow-up of 36 months, 106 patients died from all causes. Expired patients were older, more likely to be diabetic or to have experienced an atherosclerotic CV event, and exhibited a significantly greater CAC burden (p = 0.002). Survival analyses confirmed an independent association of CAC burden (hazard ratio: 1.29<br />95% confidence interval: 1.17–1.44) and CACP (HR: 5.16<br />2.61–10.21) with all-cause mortality. CACP mitigated the risk associated with CAC burden (p = 0.002), and adjustment for calcium-free phosphate binder attenuated the strength of the link between CACP and mortality. Conclusions: CAC burden and CACP predict mortality in incident to dialysis patients. However, CACP reduced the risk associated with baseline CAC, and calcium-free phosphate binders attenuated the association of CACP and outcomes, suggesting that CACP modulation may improve survival in this population. Future endeavors are needed to confirm whether drugs or kidney transplantation may attenuate CACP and improve survival in HD patients.
- Subjects :
- Adult
Male
medicine.medical_specialty
QH301-705.5
medicine.drug_class
medicine.medical_treatment
Population
030232 urology & nephrology
Coronary Artery Disease
030204 cardiovascular system & hematology
Article
03 medical and health sciences
risk prediction
0302 clinical medicine
Renal Dialysis
Renal Dialysi
Internal medicine
Post-hoc analysis
medicine
Humans
Biology (General)
Renal Insufficiency, Chronic
education
Vascular Calcification
Kidney transplantation
Coronary Vessel
Aged
Aged, 80 and over
education.field_of_study
hemodialysis
business.industry
Hazard ratio
coronary artery calcification
progression
General Medicine
Middle Aged
medicine.disease
Coronary Vessels
Confidence interval
Phosphate binder
Cardiology
Female
Hemodialysis
Hemodialysi
business
Kidney disease
Human
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Cells, Volume 10, Issue 5, Cells, Vol 10, Iss 1091, p 1091 (2021)
- Accession number :
- edsair.doi.dedup.....e5e52cc996b353a6f597b5f054138e49