Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients
BACKGROUND: Heart and coronary calcifications in hemodialysis patients are of very common occurrence and linked to cardiovascular events and mortality. Several studies have been published with similar results. Most of them were mainly cross-sectional and some of the prospective protocols were aimed...
Autores principales: | , , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903573/ https://www.ncbi.nlm.nih.gov/pubmed/20565936 http://dx.doi.org/10.1186/1471-2369-11-10 |
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author | Coen, Giorgio Pierantozzi, Andrea Spizzichino, Daniele Sardella, Daniela Mantella, Daniela Manni, Micaela Pellegrino, Luigi Romagnoli, Andrea Pacifici, Roberta Zuccaro, Piergiorgio DiGiulio, Salvatore |
author_facet | Coen, Giorgio Pierantozzi, Andrea Spizzichino, Daniele Sardella, Daniela Mantella, Daniela Manni, Micaela Pellegrino, Luigi Romagnoli, Andrea Pacifici, Roberta Zuccaro, Piergiorgio DiGiulio, Salvatore |
author_sort | Coen, Giorgio |
collection | PubMed |
description | BACKGROUND: Heart and coronary calcifications in hemodialysis patients are of very common occurrence and linked to cardiovascular events and mortality. Several studies have been published with similar results. Most of them were mainly cross-sectional and some of the prospective protocols were aimed to evaluate the results of the control of altered biochemical parameters of mineral disturbances with special regard to serum calcium, phosphate and CaxP with the use of calcium containing and calcium free phosphate chelating agents. The aim of the present study was to evaluate in hemodialysis patients classic and some non classic risk factors as predictors of calcification changes after one year and to evaluate the impact of progression on survival. METHODS: 81 patients on hemodialysis were studied, with a wide age range and HD vintage. Several classic parameters and some less classic risk factors were studied like fetuin-A, CRP, 25-OHD and leptin. Calcifications, as Agatston scores, were evaluated with Multislice CT basally and after 12-18 months. RESULTS: Coronary artery calcifications were observed in 71 of 81 patients. Non parametric correlations between Agatston scores and Age, HD Age, PTH and CRP were significant. Delta increments of Agatston scores correlated also with serum calcium, CaxP, Fetuin-A, triglycerides and serum albumin. Logistic regression analysis showed Age, PTH and serum calcium as important predictors of Delta Agatston scores. LN transformation of the not normally distributed variables restricted the significant correlations to Age, BMI and CRP. Considering the Delta Agatston scores as dependent, significant predictors were Age, PTH and HDL. A strong association was found between basal calcification scores and Delta increment at one year. By logistic analysis, the one year increments in Agatston scores were found to be predictors of mortality. Diabetic and hypertensive patients have significantly higher Delta scores. CONCLUSIONS: Progression of calcification is of common occurrence, with special regard to elevated basal scores, and is predictive of survival. Higher predictive value of survival is linked to the one year increment of calcification scores. Some classic and non classic risk factors play an important role in progression. Some of them could be controlled with appropriate management with possible improvement of mortality. |
format | Text |
id | pubmed-2903573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29035732010-07-14 Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients Coen, Giorgio Pierantozzi, Andrea Spizzichino, Daniele Sardella, Daniela Mantella, Daniela Manni, Micaela Pellegrino, Luigi Romagnoli, Andrea Pacifici, Roberta Zuccaro, Piergiorgio DiGiulio, Salvatore BMC Nephrol Research article BACKGROUND: Heart and coronary calcifications in hemodialysis patients are of very common occurrence and linked to cardiovascular events and mortality. Several studies have been published with similar results. Most of them were mainly cross-sectional and some of the prospective protocols were aimed to evaluate the results of the control of altered biochemical parameters of mineral disturbances with special regard to serum calcium, phosphate and CaxP with the use of calcium containing and calcium free phosphate chelating agents. The aim of the present study was to evaluate in hemodialysis patients classic and some non classic risk factors as predictors of calcification changes after one year and to evaluate the impact of progression on survival. METHODS: 81 patients on hemodialysis were studied, with a wide age range and HD vintage. Several classic parameters and some less classic risk factors were studied like fetuin-A, CRP, 25-OHD and leptin. Calcifications, as Agatston scores, were evaluated with Multislice CT basally and after 12-18 months. RESULTS: Coronary artery calcifications were observed in 71 of 81 patients. Non parametric correlations between Agatston scores and Age, HD Age, PTH and CRP were significant. Delta increments of Agatston scores correlated also with serum calcium, CaxP, Fetuin-A, triglycerides and serum albumin. Logistic regression analysis showed Age, PTH and serum calcium as important predictors of Delta Agatston scores. LN transformation of the not normally distributed variables restricted the significant correlations to Age, BMI and CRP. Considering the Delta Agatston scores as dependent, significant predictors were Age, PTH and HDL. A strong association was found between basal calcification scores and Delta increment at one year. By logistic analysis, the one year increments in Agatston scores were found to be predictors of mortality. Diabetic and hypertensive patients have significantly higher Delta scores. CONCLUSIONS: Progression of calcification is of common occurrence, with special regard to elevated basal scores, and is predictive of survival. Higher predictive value of survival is linked to the one year increment of calcification scores. Some classic and non classic risk factors play an important role in progression. Some of them could be controlled with appropriate management with possible improvement of mortality. BioMed Central 2010-06-21 /pmc/articles/PMC2903573/ /pubmed/20565936 http://dx.doi.org/10.1186/1471-2369-11-10 Text en Copyright ©2010 Coen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research article Coen, Giorgio Pierantozzi, Andrea Spizzichino, Daniele Sardella, Daniela Mantella, Daniela Manni, Micaela Pellegrino, Luigi Romagnoli, Andrea Pacifici, Roberta Zuccaro, Piergiorgio DiGiulio, Salvatore Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
title | Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
title_full | Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
title_fullStr | Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
title_full_unstemmed | Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
title_short | Risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
title_sort | risk factors of one year increment of coronary calcifications and survival in hemodialysis patients |
topic | Research article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903573/ https://www.ncbi.nlm.nih.gov/pubmed/20565936 http://dx.doi.org/10.1186/1471-2369-11-10 |
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