Chronic Kidney Disease as a Predictor of Coronary Lesion Morphology

Kılıçkesmez, Kadriye Orta; Abacı, Okay; Ökçün, Barış; Kocas, Cuneyt; Başkurt, Murat; Arat, Anıl; Ersanlı, Murat; Gürmen, Tevfik

doi:10.1177/0003319709351875

Cited by 16 publications

(15 citation statements)

References 40 publications

(43 reference statements)

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“…Finally, an association between mor-tality and vitamin D deficiency has been shown in dialysis-and nondialysis-dependent CKD (7,11). Because the risk of cardiovascular disease is higher in CKD than non-CKD patients, the potential benefits of vitamin D supplementation (from here on this refers to vitamin D2-ergocalciferol or D3-cholecalciferol supplementation) may be greater in CKD than non-CKD individuals (12).…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Supplementation in Chronic Kidney Disease

Kandula

Dobre

Schold

et al. 2011

Clinical Journal of the American Society of Nephrology

271

178

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SummaryBackground and objectives Vitamin D deficiency is highly prevalent among patients with chronic kidney disease (CKD). The benefits and harms of vitamin D supplementation (ergocalciferol or cholecalciferol) were assessed in patients with nondialysis-dependent CKD, dialysis-dependent CKD, and renal transplant recipients.Design, setting, participants, & measurements MEDLINE (1966 to September 2009, SCOPUS (September 2009), and nephrology conference proceedings were searched for relevant observational and randomized controlled trials (RCTs). Treatment effects were summarized as mean differences (MDs) with 95% confidence intervals (CIs) using a random effects model. Separate analyses were conducted for observational studies and RCTs.Results Twenty-two studies (17 observational and 5 RCTs) were included. There was a significant improvement in 25-hydroxyvitamin D (MD 24.1 ng/ml, 95% CI 19.6 to 28.6) and an associated decline in parathyroid hormone (PTH) levels (MD Ϫ41.7 pg/ml, 95% CI Ϫ55.8 to Ϫ27.7) among observational studies. PTH reduction was higher in dialysis patients. Among RCTs, there was a significant improvement in 25-hydroxyvitamin D (MD 14 ng/ml, 95% CI 5.6 to 22.4) and an associated decline in PTH levels (MD Ϫ31.5 pg/ ml, 95% CI Ϫ57 to Ϫ6.1). A low incidence of hypercalcemia and hyperphosphatemia was reported with vitamin D supplementation. Cardiovascular and skeletal effects of vitamin D supplementation have not been studied. Included studies were mostly of low to moderate quality.Conclusions Available evidence from low-to-moderate quality observational studies and fewer RCTs suggests that vitamin D supplementation improves biochemical endpoints. However, whether such improvements translate into clinically significant outcomes is yet to be determined.

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Section: Introductionmentioning

confidence: 99%

Vitamin D Supplementation in Chronic Kidney Disease

Kandula

Dobre

Schold

et al. 2011

Clinical Journal of the American Society of Nephrology

271

178

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“…The association between CKD and CAD has been investigated for a number of years. Kilickesmez et al (33) demonstrated that CKD has an independent influence on lesion morphology and complexity. Abaci et al (34) concluded that the eGFR was an independent predictor of the extension and severity of CAD among patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Correlation analysis between eGFRcys and SXscore in patients with diabetes

Zhong

Zhu

Tan

et al. 2014

Experimental and Therapeutic Medicine

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The aim of the present study was to explore the association between the cystatin C-based estimated glomerular filtration rate (eGFRcys) and the SYNTAX score (SXscore) in patients with diabetes. To the best of our knowledge, this correlation has not been reported previously. The eGFRcys and SXscore from 612 consecutive patients with diabetes were retrospectively included in this study. The patients were angiographically diagnosed with coronary artery disease (CAD) between July 2010 and March 2012 at the Department of Endocrinology. The SXscore was calculated using a previously described SXscore algorithm. Pearson correlations were used to analyze the correlation between eGFRcys and SXscore. Patients with renal dysfunction were older, more often female and more likely to have a history of hypertension when compared with those with normal renal function. The eGFRcys values were significantly lower and the cystatin C levels were significantly higher in the highest SXscore group than those in other groups (P<0.001). Correlation analysis indicated that eGFRcys was negatively correlated with the SXscore (r=−0.7918, P<0.001). In addition, a significantly positive correlation was identified between levels of cystatin C and the SXscore (r=0.8891, P<0.001). In conclusion, eGFRcys is an independent predictor of SXscore in patients with diabetes. The eGFRcys-estimating method may be considered important in the assessment of the SXscore in patients with diabetes.

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“…[4,5] A strong relationship between severe renal dysfunction, and extent and complexity of coronary artery disease (CAD) has been investigated in only a few previous studies. [5][6][7] It has been demonstrated that even a slight decrease in the GFR poses an independent risk factor for cardiovascular diseases. [8] However, this association was not investigated in patients with stable CAD and normal to mildly impaired renal function.…”

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confidence: 99%