Prevalence and risk factors of vascular calcification in pre-dialysis patients with Balkan endemic nephropathy

Petković, Nenad; Marić, Radmil; Gajanin, Radoslav; Batinic, Danijela; Ćuk, Mirjana; Ristić, Siniša; Djukanović, Ljubica

doi:10.2298/sarh1612608p

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…In total, 13 studies were rated as having a high risk of bias [ 20 , 23 , 24 , 25 , 26 , 28 , 29 , 32 , 33 , 37 , 39 , 40 , 41 , 43 ]. Three studies were rated as having a moderate risk [ 30 , 31 , 34 ] of bias and 12 were rated as having a low risk of bias [ 14 , 15 , 17 , 18 , 27 , 35 , 36 , 38 , 42 , 44 , 45 ].…”

Section: Resultsmentioning

confidence: 99%

Is Matrix Gla Protein Associated with Vascular Calcification? A Systematic Review

Barrett¹,

O’Keeffe²,

Kavanagh³

et al. 2018

Nutrients

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Specific patient cohorts are at increased risk of vascular calcification. Functional matrix-gla protein (MGP), a tissue-derived vitamin K dependent protein, is reported to be an important inhibitor of vascular calcification and may have clinical potential to modify the progression of vascular calcification through regulation of functional MGP fractions. This systematic review examines twenty-eight studies which assess the relationship between circulating protein expressions of MGP species and vascular calcification in different arterial beds. The included studies examined participants with atherosclerosis, chronic kidney disease (CKD), diabetes, healthy participants, vitamin K supplementation, measured plasma vitamin K levels and vitamin K antagonist usage. The current review reports conflicting results regarding MGP fractions with respect to local calcification development indicating that a multifaceted relationship exists between the MGP and calcification. A primary concern regarding the studies in this review is the large degree of variability in the calcification location assessed and the fraction of MGP measured. This review suggests that different underlying molecular mechanisms can accelerate local disease progression within the vasculature, and specific circulating fractions of MGP may be influenced differently depending on the local disease states related to vascular calcification development. Further studies examining the influence of non-functional MGP levels, with respect to specific calcified arterial beds, are warranted.

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Section: Resultsmentioning

confidence: 99%

Is Matrix Gla Protein Associated with Vascular Calcification? A Systematic Review

Barrett¹,

O’Keeffe²,

Kavanagh³

et al. 2018

Nutrients

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“…Both of these studies examined HD patients with BEN and did not examine presence of VC in BEN patients. In our previous study, we presented lower prevalence of VC in pre-dialysis BEN patients in comparison with non-BEN patients [4]. Here, we have examined the prevalence of VC in both HD and pre-dialysis BEN patients and compared it with VC in non-BEN patients.…”

Section: Discussionmentioning

confidence: 92%

“…As in pre-dialysis patients, higher VC was associated with lower iPTH levels, it could be assumed that most patients had a dynamic bone disease rather than osteitis fibrosa. Although this assumption has already been mentioned [3,4], we did not have the opportunity to check it with a bone biopsy. Despite these limitations, for the first time, we have analyzed the prevalence of VC in BEN pre-dialysis and HD patients and detected a significant difference in risk factors and prevalence of VC between BEN and non-BEN pre-dialysis patients as well as between BEN pre-dialysis and HD patients.…”

Section: Discussionmentioning

confidence: 99%

“…For BEN patients, data on chronic kidney disease-mineral and bone disorder (CKD-MBD) as well as findings concerning vascular calcification (VC) are scarce and insufficient [2,3,4]. Hyperphosphatemia, one of the main pathogenic factors of VC (as proven in many studies over the past decades [5,6]), has been found more rarely in BEN than in other chronic kidney diseases [2].…”

Section: Introductionmentioning

confidence: 99%

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Differences in Risk Factors and Prevalence of Vascular Calcification between Pre-Dialysis and Hemodialysis Balkan Nephropathy Patients

Petković¹,

Ristić

Marinković

et al. 2018

Medicina

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Aims: The aim of this study was to compare the risk factors and prevalence of vascular calcification (VC) in pre-dialysis and hemodialysis (HD) patients with Balkan endemic nephropathy (BEN) or other kidney diseases (non-BEN). Materials and Methods: The study involved 115 patients, 32 pre-dialysis and 83 HD patients, separated into groups of BEN and non-BEN patients. In addition to interviews, objective examinations and laboratory analyses, VC was assessed using Adragao score. Results: Patients with BEN were significantly older in both groups, while pre-dialysis BEN patients had significantly lower systolic blood pressure, serum cholesterol and phosphorus levels, but higher urinary excretion of phosphorus than non-BEN patients. These differences were lost in HD groups. In pre-dialysis patients, prevalence of VC was lower in BEN than in non-BEN group and mean VC score differed significantly between them (2.8 (1.7) vs. 4.6 (1.8); p = 0.009). No significant difference in VC score was found between BEN and non-BEN patients on HD. Multivariate analysis showed that in pre-dialysis patients VC score >4 was associated with lower iPTH and higher serum cholesterol level, but in the HD group with higher serum triglyceride level and longer HD vintage. Conclusions: Lower prevalence of risk factors for VC in the BEN than non-BEN patients was found in pre-dialysis but not in HD group and this was reflected in the prevalence and severity of VC in the groups. Prevalence of VC and mean VC score were significantly lower in pre-dialysis BEN than in non-BEN patients but not for those on HD.

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“…To je znatno manji procenat od onog koji su opisali drugi autori [24,25]. Najveći procenat bolesnika u našoj studiji činili su bolesnici sa endemskom nefropatijom koju odlikuje ili odsustvo ili blaga hipertenzija, a i vaskularne kalcifikacije u predijaliznom stadijumu terminalne insuficijencije bubrega su značajno rjeđe kod ovih bolesnika nego kod bolesnika sa drugim bolestima bubrega [26]. Poređenje grupe bolesnika sa gubitkom prohodnosti AVF i onih sa funkcionalnom fistulom pokazalo je da su prvi češće imali dijabetes i hipotenziju, kao i da je kvalitet njihovih vena i arterija korišćenih za kreiranje AVF bio lošiji, a period od kreiranja AVF do njenog korišćenja značajno kraći.…”

Section: Diskusijaunclassified

Factors associated with the patency loss of arteriovenous fistula for hemodialysis

Maksimović¹,

Tasić²,

Maksimović³

et al. 2018

Biomedicinska istraž.

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Uvod. Cilj rada je da se ispita učestalost ranih i kasnih postoperativnih komplikacijaarteriovenske fistule (AVF) i utvrde faktori povezani sa gubitkomprohodnosti AVF.Metode. Ispitivanje je obuhvatilo 250 bolesnika kojima je kreirana nativnapodlaktična AVF za hemodijalizu, a potom su praćeni najmanje šest mjeseci.Bolesnici su podijeljeni u dvije grupe: grupa 1, 50 bolesnika (30 muškaraca,65,9 ± 11,9 godina) kod koje je došlo do gubitka prohodnosti AVF poslije31,8 ± 38,8 mjeseci; grupa 2, 200 bolesnika (106 muškaraca, 67,6 ± 9,5 godina)sa funkcionalnom AVF praćena 57,5 ± 40,1 mjeseci. Bolesnicima su poredkliničkog stanja, funkcionalnosti AVF, redovno kontrolisani biohemijskiparametri preporučeni za bolesnike na hemodijalizi.Rezultati. U prvoj grupi bio je značajno veći procenat bolesnika sa dijabetesom(42% vs. 12%), hipotenzijom (42% vs. 2%) i anemijom (100% vs. 83,5%)u odnosu na drugu grupu, dok nije bilo razlike u demografskim, kliničkim ilaboratorijskim parametrima. Bolesnici prve grupe imali su značajno manjidijametar vene (2,4 ± 0,25 mm vs. 2,7 ± 0,31 mm; p = 0,0001), češće zadebljanzid vene (32% vs. 8%), kao i lošiji kvalitet arterije korišćene za AVF uodnosu na bolesnike druge grupe. Vrijeme od operacije AVF do njene eksploatacijebilo je značajno kraće kod bolesnika sa okluzijom AVF (28.9 ±6.6 dana vs. 95,0 ± 152,6 dana; p = 0,0025). Broj intraoperativnih, kao i ranihi kasnih postoperativnih komplikacija bio je značajno veći u prvoj negou drugoj grupi. Multivarijantna logistička regresiona analiza je izdvojila kaonezavisne faktore povezane sa gubitkom prohodnosti AVF hipotenziju, korišćenjeAVF za hemodijalizu poslije manje od 45 dana od kreiranja, broj intraoperativnihkomplikacija, dijabetes, anemiju, prethodnu kanulaciju venekorišćene za AVF, kvalitet arterije i vene i broj postoperativnih komplikacija.Zaključak. Bolesnici sa gubitkom prohodnosti AVF imali su značajno većibroj intraoperativnih i postoperativnih komplikacija. Gubitak prohodnostiAVF povezan je sa nizom promjenljivih faktora rizika čije prepoznavanje ieliminisanje može da poboljša funkcionisanja AVF i produži vrijeme njeneeksploatacije.

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Prevalence and risk factors of vascular calcification in pre-dialysis patients with Balkan endemic nephropathy

Abstract: Pre-dialysis BEN patients had a significantly lower mean score of VC than patients with other kidney diseases.

Cited by 4 publications

References 25 publications

Is Matrix Gla Protein Associated with Vascular Calcification? A Systematic Review

Is Matrix Gla Protein Associated with Vascular Calcification? A Systematic Review

Differences in Risk Factors and Prevalence of Vascular Calcification between Pre-Dialysis and Hemodialysis Balkan Nephropathy Patients

Factors associated with the patency loss of arteriovenous fistula for hemodialysis

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