Hyperphosphatemia as an independent risk factor for coronary artery calcification progression in peritoneal dialysis patients

Xie

BioMed Research International

et al. 2017

Self Cite

Background. Coronary artery calcification (CAC) contributes to high risk of cardiocerebrovascular diseases in dialysis patients. However, the risk factors for CAC initiation in peritoneal dialysis (PD) patients are not known clearly. Methods. Adult patients with baseline CaCS = 0 and who were followed up for at least 3 years or until the conversion from absent to any measurable CAC detected were included in this observational cohort study. Binary logistic regression was performed to identify the risk factors for CAC initiation in PD patients. Results. 70 patients recruited to our study were split into a noninitiation group (n = 37) and an initiation group (n = 33) according to the conversion of any measurable CAC during their follow-up or not. In univariate analysis, systolic blood pressure, serum phosphorus, fibrinogen, hs-CRP, serum creatinine, and triglycerides were positively associated with the initiation of CAC, while the high density lipoprotein and nPCR did the opposite function. Multivariate analysis revealed that hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation after adjustments. Conclusions. Hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation in PD patients. These results suggested potential clinical strategies to prevent the initiation of CAC in PD patients.

Section: Discussionsupporting

confidence: 64%

“…The CaCS was recorded as just as we previous described [6, 14]. Demographic characteristics and comorbidities (diabetes mellitus, hypertension, and CVD) were recorded at baseline.…”

Section: Methodsmentioning

confidence: 99%

Hyperphosphatemia and hs-CRP Initiate the Coronary Artery Calcification in Peritoneal Dialysis Patients

Xie

BioMed Research International

et al. 2017

Self Cite

“…In fact, higher serum phosphate concentrations falling within the normal range are associated with cardiovascular events and mortality in patients with normal and abnormal kidney function (9,87). A recent study by Shang et al (88) showed that hyperphosphatemia is an independent risk factor in the progression of coronary artery calcification. Phosphate levels were positively associated with protein intake and peritoneal dialysis adequacy, suggesting that restriction of phosphate intake may be useful in slowing the progression of vascular calcification.…”

Section: Phosphate and Cardiovascular Diseasementioning

confidence: 99%

Phosphate Toxicity in CKD: The Killer among Us

Ritter¹,

Slatopolsky²

2016

CJASN

118

113

Maintenance of a normal serum phosphate level depends on absorption in the gut, reabsorption and excretion by the kidney, and the flux between the extracellular and skeletal pools. Phosphate homeostasis is a coordinated, complex system of crosstalk between the bone, intestine, kidney, and parathyroid gland. Dysfunction of this system has serious clinical consequences in healthy individuals and those with conditions, such as CKD, in which hyperphosphatemia is associated with increased risks of cardiovascular morbidity and mortality. The last halfcentury of renal research has helped define the contribution of the parathyroid hormone, calcitriol, fibroblast growth factor 23, and Klotho in the regulation of phosphate. However, despite new discoveries and insights gained during this time, what remains unchanged is the recognition that phosphate retention is the initiating factor for the development of many of the complications observed in CKD, namely secondary hyperparathyroidism and bone and cardiovascular diseases. Controlling phosphate load remains the primary goal in the treatment of CKD. This review discusses the clinical effects of dysregulated phosphate metabolism, particularly in CKD, and its association with cardiovascular disease. The importance of early control of phosphate load in the treatment of CKD is emphasized, and the latest research in the treatment of phosphate retention is discussed.

“…12,13 According to Shang's study, hyperphosphatemia is an independent risk factor for coronary artery calcification progression. 27 Vascular calcification is an early feature of CKD patients and its progression is linked to high phosphate load and hyperphosphatemia. Therefore, Lioufas suggests a reduction of the level of phosphatemia in chronic renal failure to reduce the risk of vascular calcification.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors in chronic renal failure patient at Soavinandriana Hospital Antananarivo

et al. 2020

Background: Cardiovascular disease (CVD) is the primary cause of morbidity and premature mortality in chronic kidney disease (CKD). The aim of this study was to assess the frequency of cardiovascular disease and cardiovascular risk in haemodialysis population for chronic kidney disease.Methods: This was a retrospective and descriptive study for a period of 4 years from January 2016 to December 2019, performed at hemodialysis unit in Soavinandriana Hospital Center Antananarivo, including all patients, following regular hemodialysis for chronic renal failure. Demographic data, cardiovascular disease, cardiovascular risk factors, aetiology of nephropathy, haemoglobin <11 g/dl, phosphocalcic metabolism disorders and uricemia were analyzed.Results: Seventy-six patients were recorded, including 46 males (60.52%) and were women (39.47%). The average age was 59.98 years old. The risk factors of cardiovascular disease were smoking (22.36%), diabetes mellitus (46.05%), high blood pressure (71.05%), dyslipidemia (47.36%) and obesity (11.84%). Fifty-eight patients (76.31%) had a high cardiovascular risk factor. Seventy patients (22.36%) had had a history of cardiovascular diseases. Fifty-nine patients had a haemoglobin concentration under 11 g/dl (77.63%). There were 23 cases of hypocalcemia (30.26%), 22 cases of hyperphosphatemia (28.94%) and 37 cases of hyperuricemia (48.68%).Conclusions: There was a high cardiovascular risk factor in this study population. Early detection of cardiovascular diseases should be done in patients who have a high-risk factor of cardiovascular disease to decrease the mortality rate in chronic kidney diseases population. The appropriate management of modifiable risk factors is important to improve the survival of this study patients.