Abdominal aortic calcification in patients with CKD

Abstract

BackgroundAbdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients.MethodsWe included patients with CKD not receiving renal replacement therapy from the MASTERPLAN study, a randomized controlled trial that started in 2004. In the period 2008–2009, an X-ray to evaluate AAC was performed in a subgroup of patients. We studied AAC using a semi-quantitative scoring system by lateral lumbar X-ray. We used baseline and 2-year data to find determinants of AAC. We used a composite cardiovascular endpoint and propensity score matching to evaluate the prognostic value of AAC.ResultsIn 280 patients an X-ray was performed. In 79 patients (28 %) the X-ray showed no calcification, in 62 patients (22 %) calcification was minor (<4), while 139 patients (50 %) had moderate or heavy calcification (≥4). Older age, prior cardiovascular disease, higher triglyceride levels, and higher phosphate levels were independent determinants of a calcification score ≥4. AAC score ≥4 was independently associated with cardiovascular events, with a hazard ratio of 5.5 (95 % confidence interval 1.2–24.8).ConclusionsAssessment of AAC can identify CKD patients at higher cardiovascular risk, and may provide important information for personalized treatment. Whether this approach will ultimately translate into better outcomes remains to be answered.Electronic supplementary materialThe online version of this article (doi:10.1007/s40620-015-0260-7) contains supplementary material, which is available to authorized users.

Abdominal aortic calcification score can predict future coronary artery disease in hemodialysis patients: a 5-year prospective cohort study

“…Vascular calcification is commonly seen in chronic kidney disease (CKD) patients [ 1 , 2 ]. The prevalence of vascular calcification in end stage renal disease patients can be as high as 81% in a cross-sectional study [ 3 ].…”

Maximal Stress Ergometry Performance is Associated with Troponin T and Abdominal Aortic Calcification Score in Severe Chronic Kidney Disease

“…The association between TnT and WMAX% also remained signi cant after controlling for previously diagnosed CAD in the multivariable model. AAC is independently associated with cardiovascular events in the general population and in dialysis patients and the KDOQI Work Group recommends the assessment of AAC for risk strati cation in CKD [10][11][12]. There are no previous data available on the association between AAC and maximal ergometry performance or other physical stress tests in patients with CKD.…”

“…AAC is independently associated with cardiovascular events in the general population and in dialysis patients [11,12]. Previous studies have shown that AAC is independently associated with coronary artery calci cation [13], left ventricular diastolic dysfunction [14], and increased risk for incident claudication [15], all of which may lead to diminished physical performance in CKD.…”

Calcification of Heart and Vessels in Chronic Kidney Disease: Problems of Etiology and Pathogenesis

“…Водночас певна роль у формуванні ектопічної кальцифікації в умовах хронічної дисфункції нирок належить пасивним механізмам [4]. Кардіоваскулярна кальцифікація є серйозним ускладненням ХХН, незалежним предиктором загальної і серцево-судинної смертності та компонентом синдрому мінеральних і кісткових порушень при ХХН -ХХН-МКП [1,6,7]. Частота, ви-разність, розповсюдженість кальцифікації серця й судин у хворих на ХХН у 5-10 разів є вищою, ніж у загальній популяції, зустрі-чається в осіб молодого віку, асоціюється зі зниженням ниркової функції та тривалістю діалізного лікування [4,8,9].…”