Comparing different calcification scores to detect outcomes in chronic kidney disease patients with vascular calcification

Nasrallah, M. M.; Nassef, Ashraf O.; Elshaboni, Tarik H.; Morise, Fadia; Osman, Noha A.; Din, Usama A Sharaf El

doi:10.1016/j.ijcard.2016.06.064

Cited by 22 publications

(26 citation statements)

References 29 publications

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“…[ 47 ] Previous study supported that CT appeared to be more sensitive than plain X-rays at detecting vascular calcifications in hemodialysis patients. [ 48 ] Tsushima et al developed a method to measure the percentage of calcified volume against whole vascular volume using CT [ 17 , 18 ] and Mori et al also described and validated a new volume-rendering approach to quantify aortic calcification using commercially available software. [ 49 ] Currently, CT remains the reference standard in the measurement of AAC.…”

Section: Discussionmentioning

confidence: 99%

Abdominal aorta calcification predicts cardiovascular but not non-cardiovascular outcome in patients receiving peritoneal dialysis

Tsai

Lin

et al. 2020

Medicine

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Abdominal aorta calcification (AAC) is associated with worse clinical outcomes in dialysis patients. However, the long-term prognostic values of AAC to cardiovascular (CV) and non-CV mortality in patients starting peritoneal dialysis (PD) remain unknown. This study is aimed to the analyze the predictive power of AAC to CV and non-CV mortality in PD patients. We prospectively enrolled 123 patients undergoing PD. All patients received quantitative analysis of AAC via abdominal computer tomography at enrollment. The AAC ratio was measured by the area of the whole aorta affected by aortic calcification above the iliac bifurcation. The CV mortality and non-CV mortality during the follow-up period were investigated using the Cox proportional hazard model and time-dependent receiver operating characteristic (ROC) analysis. After median 6.8 (interquartile range, 3.6–9.2) years of follow-up, there were 18 CV mortality, 24 non-CV mortality and 42 total mortality. The age and AAC ratio were significantly higher in CV mortality group compared with others without CV mortality. In time-dependent ROC analysis, AAC had excellent predictive power of CV mortality (AUC:0.787) but not non-CV mortality (AUC:0.537). The best cutoff value of AAC ratio to predict CV mortality was 39%. In addition, AAC was not associated with non-CV mortality but remained to be a significantly predictor of CV mortality after adjusted with clinical covariates in different Cox proportional hazard models. AAC has excellent prognostic value of CV mortality but is unable to predict non-CV morality in patients undergoing PD.

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Section: Discussionmentioning

confidence: 99%

Abdominal aorta calcification predicts cardiovascular but not non-cardiovascular outcome in patients receiving peritoneal dialysis

Tsai

Lin

et al. 2020

Medicine

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“…In hemodialysis patients, the prevalence of aortic calcification was high and the severity was associated with aging, male gender, diabetes, increased systolic blood pressure, increased serum calcium and phosphate and longer dialysis vintage[92,93]. Aortic calcification was observed with increasing frequency from the thoracic aorta to upper abdominal aorta and lower abdominal aorta[94]. In two cohorts of maintenance hemodialysis patients, abdominal aortic calcification predicted CV and overall mortality and nonfatal CV events[93,95].…”

Section: Ctmentioning

confidence: 99%

“…In two cohorts of maintenance hemodialysis patients, abdominal aortic calcification predicted CV and overall mortality and nonfatal CV events[93,95]. Calcification of the lower part of abdominal aorta appeared to be the most predictive of CV events and mortality[94]. In non-dialysis CKD patients, the prevalence of calcification in abdominal aorta was 50% in CKD stage 3 and 80%-90% in CKD stages 4-5.…”

Section: Ctmentioning

confidence: 99%

Role of different imaging modalities of vascular calcification in predicting outcomes in chronic kidney disease

Disthabanchong

Boongird

2017

WJN

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Vascular calcification (VC) is common among patients with chronic kidney disease (CKD). The severity of VC is associated with increased risk of cardiovascular events and mortality. Risk factors for VC include traditional cardiovascular risk factors as well as CKD-related risk factors such as increased calcium and phosphate load. VC is observed in arteries of all sizes from small arterioles to aorta, both in the intima and the media of arterial wall. Several imaging techniques have been utilized in the evaluation of the extent and the severity of VC. Plain radiographs are simple and readily available but with the limitation of decreased sensitivity and subjective and semi-quantitative quantification methods. Mammography, especially useful among women, offers a unique way to study breast arterial calcification, which is largely a medial-type calcification. Ultrasonography is suitable for calcification in superficial arteries. Analyses of wall thickness and lumen size are also possible. Computed tomography (CT) scan, the gold standard, is the most sensitive technique for evaluation of VC. CT scan of coronary artery calcification is not only useful for cardiovascular risk stratification but also offers an accurate and an objective analysis of the severity and progression.

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“…In contrast, abdominal aortic calcification (AAC) has been rarely used as a marker to diagnose atherosclerosis or a tool to assessment the risk of CV events [ 9 ]. But in some studies, AAC has been shown to be an independent risk factor for all-cause mortality or CV events in the general population [ 4 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…But in some studies, AAC has been shown to be an independent risk factor for all-cause mortality or CV events in the general population [ 4 , 10 , 11 ]. The presence of AAC was closely related to increased risk of adverse outcomes of dialysis patients [ 9 , 12 – 16 ]. However, studies published to date have not reached consistent conclusions regarding the presence or extent of AAC and CV or all-cause mortality in maintenance dialysis patients.…”

Section: Introductionmentioning

confidence: 99%

Abdominal aortic calcification can predict all-cause mortality and CV events in dialysis patients: A systematic review and meta-analysis

et al. 2018

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BackgroundAbdominal aortic calcification (AAC) has a pretty high incidence in dialysis patients and may be associated with their prognosis. AAC can be assessed by abdominal CT or X-ray. We determined to investigate whether the occurrence of AAC is associated with all-cause mortality and cardiovascular (CV) events in dialysis patients through this meta-analysis and systematic review.MethodsA comprehensive literature search was conducted using the PubMed, Cochrane library, Embase, Medline databases to collect cohort studies investigating whether AAC is associated with all-cause mortality and CV events of patients, and we also searched gray articles and conferences abstracts. Meta-analysis was performed by STATA software. Pooled results were expressed as hazard ratio (HR) with corresponding 95% confidence intervals (CI). Fixed-effect models were used to pool the HR of each trial.Results10 studies (2,724 dialysis patients) were identified. The presence of AAC was associated with increased risk for all-cause mortality among dialysis patients (HR, 2.84; 95% CI, 2.03–3.98; I2 = 9.8%; P = 0.354). Meanwhile, there was an association between AAC and increased risk for all CV events (fatal and non-fatal) in patients (HR, 2.04; 95% CI, 1.51–2.76, I2 = 44.6%; P = 0.125). 3 studies presented their endpoint as CV mortality, and the pooled HR was 2.46 (95%CI 1.38–4.40; I2 = 0.0%; P = 0.952).There were also 2 studies that reported their primary endpoint as all-cause mortality and CV events, and the pooled HR was 5.72 (95% CI 3.24–10.10; I2 = 0.0%; P = 0.453).ConclusionsAmong patients treated with dialysis, AAC is associated with adverse outcomes, including all-cause mortality and CV events (fatal and non-fatal). The abdominal X-ray or CT scan can be used as a useful added method to evaluate the patient’s calcification. This may provide reasonable data for estimating the risk of adverse events in dialysis patients, which is helpful in guiding clinical treatment and improving the prognosis of dialysis patients.

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Comparing different calcification scores to detect outcomes in chronic kidney disease patients with vascular calcification

Cited by 22 publications

References 29 publications

Abdominal aorta calcification predicts cardiovascular but not non-cardiovascular outcome in patients receiving peritoneal dialysis

Abdominal aorta calcification predicts cardiovascular but not non-cardiovascular outcome in patients receiving peritoneal dialysis

Role of different imaging modalities of vascular calcification in predicting outcomes in chronic kidney disease

Abdominal aortic calcification can predict all-cause mortality and CV events in dialysis patients: A systematic review and meta-analysis

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