Safety of Low-calcium Dialysate and its Effects on Coronary Artery Calcification in Patients Undergoing Maintenance Hemodialysis

Yang, Wen; Gan, Hua; Li, Zhengrong; Sun, Xiaobo; Xiong, Ying; Xia, Yunlong

doi:10.1038/s41598-018-24397-w

Cited by 8 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Russo et al have reported that coronary artery calcification (CAC) was more prevalent in patients with diabetes mellitus [ 2 ]. Additionally, the risk for death in patients with CKD has been estimated to be 8 times higher than that in the general population, and CVD accounts for more than 50% of the deaths in patients with CKD [ 3 ]. Vascular calcification is an important risk factor for CVD in patients with CKD, and approximately 54–100% of patients have vascular calcifications [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of coronary artery calcification and its association with cardiovascular events in patients with chronic kidney disease

et al. 2021

View full text Add to dashboard Cite

Objective To investigate the predictors of coronary artery calcification (CAC) and its association with cardiovascular events (CVE) in patients with stage 3–5 chronic kidney disease (CKD). Method Two hundred ninety CKD patients in our nephrology department were enrolled from 2018 to May 2019. The levels of matrix Gla protein (MGP) and interleukin 6 (IL-6) were measured via enzyme-linked immunosorbent assay (ELISA) method in 131 CKD patients of all. CAC was evaluated via computed tomography (CT). The covariate factors were analyzed by binary logistic regression analysis. We conducted the visits to explore the prevalence of CVE in 276 CKD patients, and covariate factors were analyzed by Cox proportional hazard model. Results The prevalence of CAC was up to 57.93%. We found that age, diabetes mellitus, hyperphosphatemia, dialysis duration, and the neutrophil-lymphocyte ratio (NLR) were positively associated with CAC in all patients. In 131 patients, we demonstrated that higher IL-6 and lower MGP levels were associated with CAC. A Cox proportional hazard model demonstrated that moderate to severe CAC was correlated with an increased risk for CVE [Hazard Ratio (HR): 7.250; 95% confidence interval (CI): 3.192–16.470], and a higher MGP level was associated with a reduced risk for CVE (HR: 0.340; 95% CI: 0.124–0.933). Conclusions The prevalence of CAC in patients with CKD is a significant issue. Older age, hyperphosphatemia, dialysis duration, diabetes mellitus, IL-6, and the NLR are associated with CAC. In addition, higher MGP levels represent protective factor for CAC. Moderate to severe CAC, and lower MGP levels are associated with an increased risk for CVE. Abbreviations : AGEs: Advanced glycosylation end products; CAC: Coronary artery calcification; CACS: Coronary artery calcification score; Ca: Calcium; CI: confidence interval; CKD: Chronic kidney disease; CVE: Cardiovascular events; CT: Computed tomography; ELISA: Enzyme-linked immunosorbent assay; Hb: hemoglobin; HR: Hazard ratio; hs-CRP: high-sensitivity C-reactive protein; IL-6: Interleukin 6; iPTH: Intact parathyroid hormone; Mg: Magnesium; MGP: Matrix Gla protein; NF-κB: nuclear factor-kappa gene binding; NRL: Neutrophil-lymphocyte ratio; Runx2: Runt-related transcription factor 2; RRT: Renal replacement therapy; P: Phosphorus; Scr: Serum creatinine; TNF--alpha: Tumor necrosis factor--alpha; TC: Total cholesterol; TG: Triglyceride; VSMC: vascular smooth muscle cel

show abstract

Section: Introductionmentioning

confidence: 99%

Predictors of coronary artery calcification and its association with cardiovascular events in patients with chronic kidney disease

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Indeed, a study of young patients with ESRD who were undergoing dialysis also con rmed that there was no signi cant difference in serum phosphorus between patients with or without coronary artery calci cation 28 . Another study involving 174 Chinese patients also found that age may be the most important factor affecting coronary artery calci cation in maintenance hemodialysis patients 34 .…”

Section: Discussionmentioning

confidence: 96%

Relationship Between Parathyroid Hormone Levels and Abdominal Aortic Calcification in Incident Hemodialysis Patients Not Treated with Calcium or Vitamin D

Chen

Mao

et al. 2021

Preprint

View full text Add to dashboard Cite

Vascular calcification (VC) and secondary hyperparathyroidism (SHPT) are important causes of high incidence of cardiovascular events in chronic kidney disease (CKD) patients. The relationship between parathyroid hormone (PTH) and VC is very complex. Different studies have inconsistent reports on the effect of PTH on VC. The present study investigated the correlation between PTH levels and abdominal aortic calcification (AAC) in incident hemodialysis patients who did not receive calcium, calcium-containing phosphorus binders, calcitriol or vitamin D analogs. Our data confirm that serum PTH levels is significantly negatively correlated with AAC within a certain concentration range in incident hemodialysis patients who not treated with calcium or vitamin D.

show abstract

“…The risks of death in chronic kidney disease (CKD) patients are eight times higher than that of the general population, and cardiovascular disease (CVD) accounts for more than 50% of the causes 1 . As an important component of vascular calcification (VC), coronary artery calcification (CAC) is closely related to CVD and high mortality in patients with CKD 2 .…”

Section: Introductionmentioning

confidence: 99%

Predictive Model for Severe Coronary Artery Calcification in ESKD Patients

Tang,

Qian,

Zeng

et al. 2023

Preprint

View full text Add to dashboard Cite

IntroductionThe Agatston coronary artery calcification score (CACS) is an assessment index for coronary artery calcification (CAC). This study aims to explore the characteristics of CAC in end-stage kidney disease (ESKD) patients and establish a predictive model to assess the risk of severe CAC in patients.MethodsCACS of ESKD patients was assessed using an electrocardiogram-gated coronary computed tomography (CT) scan with the Agatston scoring method. A predictive nomogram model was established based on stepwise regression. An independent validation cohort comprised of patients with ESKD from multicentres.Results369 ESKD patients were enrolled in the training set, and 127 patients were included in the validation set. In the training set, the patients were divided into three subgroups: no calcification (CACS = 0, n = 98), mild calcification (0 < CACS ≤ 400, n = 141) and severe calcification (CACS > 400, n = 130). Among the four coronary branches, the left anterior descending branch (LAD) accounted for the highest proportion of calcification. Stepwise regression analysis showed that age, dialysis vintage, β-receptor blocker, calcium-phosphorus product (Ca × P), and alkaline phosphatase (ALP) level were independent risk factors for severe CAC. A nomogram that predicts the risk of severe CAC in ESKD patients has been internally and externally validated, demonstrating high sensitivity and specificity.ConclusionCAC is both prevalent and severe in ESKD patients. In the four branches of the coronary arteries, LAD calcification is the most common. Our validated nomogram model, based on clinical risk factors, can help predict the risk of severe coronary calcification in ESKD patients who cannot undergo coronary CT analysis.

show abstract

Safety of Low-calcium Dialysate and its Effects on Coronary Artery Calcification in Patients Undergoing Maintenance Hemodialysis

Cited by 8 publications

References 24 publications

Predictors of coronary artery calcification and its association with cardiovascular events in patients with chronic kidney disease

Predictors of coronary artery calcification and its association with cardiovascular events in patients with chronic kidney disease

Relationship Between Parathyroid Hormone Levels and Abdominal Aortic Calcification in Incident Hemodialysis Patients Not Treated with Calcium or Vitamin D

Predictive Model for Severe Coronary Artery Calcification in ESKD Patients

Contact Info

Product

Resources

About