Prevalence of and Predictive Factor for Abdominal Aortic Calcification in Thai Chronic Kidney Disease Patients

Abstract

Presence and severity of cardiovascular calcifications strongly predict cardiovascular morbidity and mortality in patients with CKD. This multicenter, crosssectional study primarily aimed to determine prevalence of abdominal aortic calcification (AAC) detected by plain lateral abdominal radiograph, and secondarily aimed to assess predictive factors for AAC. Patients (N = 1500), aged 18-70 years, with CKD stages 3-5D for ≥3 months prior to evaluation, were enrolled at 24 study centers in Thailand; 54.3% were non-dialysis patients. The prevalence of AAC was 70.6% and 70.8% in non-dialysis and dialysis patients, respectively. Patient's advanced age and widening pulse pressure were identified as predictive factors for AAC ≥ 5 in non-dialysis patients, while patient's age, history of coronary heart disease or diabetes, longer dialysis vintage, and increasing corrected serum calcium or high-sensitivity C-reactive protein were identified as such in dialysis patients. With additional regression having covariates in binary, corrected serum calcium ≥9.5 mg/dL gave an OR 1.974 (95% CI: 1.324-2.943) for AAC ≥ 5 among the dialysis patients. AAC in diabetes subgroup (N = 692) was additionally evaluated and found that it was prevalent at 84.7% with increased phosphorus as predictive factor (OR, 1.178; 95% CI: 1.032-1.344) and 1,25 (OH) 2 vitamin D as protective factor (OR, 0.983; 95% CI,.The prevalence of AAC in the Thai CKD population is lower than that reported in the literature, and yet the burden is prominent in patients coexisting with diabetes. Variable relationships identified in this study may guide preventive measures against cardiovascular complications in CKD patients.

Abdominal Aortic Calcification Score as a Predictor of Clinical Outcome in Peritoneal Dialysis Patients: A Prospective Cohort Study

“…We reported an abdominal artery calcification prevalence of 57.2% in our PD patients, in correspondence with published meta results in Asia population [4]. There were a few cross-sectional studies suggesting that abdominal artery calcification might be less common in PD patients compared to HD patients [14], while other studies reported no advantage of one modality over the other [4,17].…”

“…Abdominal artery calcification is particularly common in dialysis patients, with the overall prevalence ranging from one third to more than 80 percent [4,[14][15][16]. We reported an abdominal artery calcification prevalence of 57.2% in our PD patients, in correspondence with published meta results in Asia population [4].…”

Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study

“…Abdominal artery calcification is particularly common in dialysis patients, with the overall prevalence ranging from one third to more than 80% [4,[14][15][16]. We reported an abdominal artery calcification prevalence of 57.2% in our PD patients, in correspondence with published meta results in Asia population [4].…”

Lipid levels are inversely associated with infectious and all-cause mortality: international MONDO study results

“…Infection has been shown to affect the structure of lipoproteins ( 22 , 23 ) and lipoprotein structure independent of lipoprotein concentration has also been shown to be associated with infectious risk ( 36 ). The lack of an association between lipids, and specifically LDL-C and CV outcomes, may be that non-lipoprotein-related processes associated with inflammation ( 18 , 37 , 38 ) or calcium and phosphorous metabolism ( 39 , 40 ) that play a more limited role in the general population are responsible for the large increase in CVD outcomes ( 1 ) and dominate CVD outcomes in dialysis patients, obscuring lipoprotein-related pathways of injury. Analysis of patients enrolled in the CHOICE study found that total cholesterol increased CVD risk if only subjects who were not inflamed were included in the analysis ( 37 , 38 ); nevertheless, in that study, the mortality risk for uninflamed patients with high total cholesterol was significantly less than that for inflamed patients at any level of cholesterol.…”