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...

Descripción completa

Detalles Bibliográficos
Autores principales: Coen, Giorgio, Pierantozzi, Andrea, Spizzichino, Daniele, Sardella, Daniela, Mantella, Daniela, Manni, Micaela, Pellegrino, Luigi, Romagnoli, Andrea, Pacifici, Roberta, Zuccaro, Piergiorgio, DiGiulio, Salvatore
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
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
_version_ 1782183818271129600
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
work_keys_str_mv AT coengiorgio riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT pierantozziandrea riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT spizzichinodaniele riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT sardelladaniela riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT mantelladaniela riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT mannimicaela riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT pellegrinoluigi riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT romagnoliandrea riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT pacificiroberta riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT zuccaropiergiorgio riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients
AT digiuliosalvatore riskfactorsofoneyearincrementofcoronarycalcificationsandsurvivalinhemodialysispatients