Impact of Cardiovascular Calcification in Nondialyzed Patients after 24 Months of Follow-up
- 1 February 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 5 (2), 189-194
- https://doi.org/10.2215/cjn.06240909
Abstract
Background and objectives: Coronary artery calcification (CAC) is highly prevalent among patients with chronic kidney disease (CKD), and it has been described as a strong predictor of mortality in the dialysis population. Because there is a lack of information regarding cardiovascular calcification and clinical outcomes in the earlier stages of the disease, we aimed to evaluate the impact of CAC on cardiovascular events, hospitalization, and mortality in nondialyzed patients with CKD. Design, setting, participants, & measurements: This is a prospective study including 117 nondialyzed patients with CKD (age, 57 ± 11.2 years; 61% male; 23% diabetics; creatinine clearance, 36.6 ± 17.8 ml/min per 1.73 m2). CAC was quantified by multislice computed tomography. The occurrence of cardiovascular events, hospitalization, and death was recorded over 24 months. Results: CAC >10 Agatston units (AU) was observed in 48% of the patients [334 (108 to 858.5) AU; median (interquartiles)], and calcification score ≥400 AU was found in 21% [873 (436–2500) AU]. During the follow-up, the occurrence of 15 cardiovascular events, 19 hospitalizations, and 4 deaths was registered. The presence of CAC >10 AU was associated with shorter hospitalization event-free time and lower survival. CAC ≥400 AU was additionally associated with shorter cardiovascular event-free time. Adjusting for age and diabetes, CAC ≥400 AU was independently associated with the occurrence of hospitalization and cardiovascular events. Conclusions: Cardiovascular events, hospitalization, and mortality were associated with the presence of CAC in nondialyzed patients with CKD. Severe CAC was a predictor of cardiovascular events and hospitalization in these patients.Keywords
This publication has 27 references indexed in Scilit:
- Incidence and progression of coronary calcification in chronic kidney disease: the Multi-Ethnic Study of AtherosclerosisKidney International, 2009
- Prevalence and Associations of Coronary Artery Calcification in Patients With Stages 3 to 5 CKD Without Cardiovascular DiseaseAmerican Journal of Kidney Diseases, 2008
- Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patientsKidney International, 2007
- Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and HospitalizationNew England Journal of Medicine, 2004
- Longitudinal Follow-up and Outcomes Among a Population With Chronic Kidney Disease in a Large Managed Care OrganizationArchives of Internal Medicine, 2004
- Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysisClinical and Experimental Nephrology, 2004
- Cardiovascular Calcifications in Uremic PatientsJournal of the American Society of Nephrology, 2003
- Coronary artery, aortic wall, and valvular calcification in nondialyzed individuals with type 2 diabetes and renal diseaseKidney International, 2003
- Vascular calcification in the uremic patient: A cardiovascular risk?Kidney International, 2003
- Cardiac calcification in adult hemodialysis patientsJournal of the American College of Cardiology, 2002