Severe aortic arch calcification predicts mortality in patients undergoing peritoneal dialysis: Methodological issues

Background/Aims: Aortic arch calcification (AoAC) is a fatal complication in dialysis. AoAC progression-related molecules in continuous ambulatory peritoneal dialysis (CAPD) remain unclear. Methods: AoAC was estimated using plain chest radiography scoring (AoACS) in 30 CAPD patients (age 49.3 ± 13.4 years). AoAC progression was defined as increased AoACS on follow-up chest X-ray at the end of the study (progressors). Fibroblast growth factor-23 and osteoprotegerin (OPG) were measured. Results: Median follow-up was 38.5 months. Progressors were older, had shorter PD vintage, higher body mass index, and higher serum OPG levels (255.6 ± 109.2 pg/mL) than nonprogressors (183.4 ± 68.2 pg/mL; p = 0.0400). Progressors also showed higher pulse pressure (62.4 ± 20.0 mm Hg) and pulse wave velocity (1,909.9 ± 310.6 cm/s) than nonprogressors (48.5 ± 13.6 mm Hg; p = 0.0030 and 1,390.1 ± 252.8 cm/s; p = 0.0005, respectively). Conclusion: AoAC progression was associated with increased aortic stiffness. OPG may be associated with AoAC progression in CAPD.

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P1258CLINICAL COMPARATIVE STUDY OF AORTIC ARCH CALCIFICATION IN PATIENTS WITH MAINTENANCE PERITONEAL DIALYSIS AND HEMODIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1258 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Junhui Li ◽

Niansong Wang

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Comparative Study ◽

Aortic Arch ◽

Vascular Calcification ◽

Binary Logistic Regression Analysis ◽

Risk Of Mortality ◽

Increased Risk ◽

Independent Risk Factors ◽

Aortic Arch Calcification

Abstract Background and Aims Vascular calcification is known to be an important risk factor in patients with dialysis, However, the comparative study on vascular calcification between peritoneal dialysis (PD) and hemodialysis (HD) is less. The aim of this study was to analyze the presence, risk factors of aortic arch calcification (AAC), and compare the prognosis in maintenance PD and HD patients. Method Using retrospective analysis method, 177 patients with PD and 147 patients with HD were included in the study. The extent of AAC was evaluated by chest X-ray examination. The demographic characteristics and clinical data were collected and compared between PD group and HD group. Binary logistic regression analysis was performed to evaluate risk factors associated with the aortic arch calcification. Results The incidence of AAC in HD group (59.86%) was significantly higher than that in PD group (37.29%). Multivariate analysis showed that age, residual renal function (RRF) and serum phosphate were the independent risk factors for calcification of PD patients and the odds ratio (OR) values were 1.133, 1.039, 0.762 and 18.186, respectively. Similarly, age, RRF, calcium-phosphorus product and LDL were the risk factors of HD patients and their respective OR values were 1.125, 0.509, 2.755 and 3.221. Compared with patients without AAC, the presence of moderate-severe AAC was associated with greater risk of mortality, and the OR values were 17.833 and 20.056 in PD group and HD group, respectively. Conclusion Our findings suggest that the AAC was more common in HD patients. Older age and lower RRF are common independent risk factors for AAC in PD and HD patients. Moderate to severe AAC a ppears to be associated with increased risk of mortality.

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Progression of Aortic Arch Calcification Over 1 Year Is an Independent Predictor of Mortality in Incident Peritoneal Dialysis Patients

PLoS ONE ◽

10.1371/journal.pone.0048793 ◽

2012 ◽

Vol 7 (11) ◽

pp. e48793 ◽

Cited By ~ 14

Author(s):

Mi Jung Lee ◽

Dong Ho Shin ◽

Seung Jun Kim ◽

Hyung Jung Oh ◽

Dong Eun Yoo ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Aortic Arch ◽

Independent Predictor ◽

Dialysis Patients ◽

Aortic Arch Calcification

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Evaluation of aortic arch calcification in type 2 diabetic patients

VASA ◽

10.1024/0301-1526.34.2.113 ◽

2005 ◽

Vol 34 (2) ◽

pp. 113-117 ◽

Cited By ~ 4

Author(s):

Papanas ◽

Symeonidis ◽

Maltezos ◽

Giannakis ◽

Mavridis ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Aortic Arch ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Insulin Dependence ◽

Artery Disease ◽

Type 2 Diabetic ◽

Aortic Arch Calcification

Background: The purpose of this study is to evaluate the severity of aortic arch calcification among type 2 diabetic patients in association with diabetes duration, diabetic complications, coronary artery disease and presence of cardiovascular risk factors. Patients and methods: This study included 207 type 2 diabetic patients (101 men) with a mean age of 61.5 ± 8.1 years and a mean diabetes duration of 13.9 ± 6.4 years. Aortic arch calcification was assessed by means of posteroanterior chest X-rays. Severity of calcification was graded as follows: grade 0 (no visible calcification), grade 1 (small spots of calcification or single thin calcification of the aortic knob), grade 2 (one or more areas of thick calcification), grade 3 (circular calcification of the aortic knob). Results: Severity of calcification was grade 0 in 84 patients (40.58%), grade 1 in 64 patients (30.92%), grade 2 in 43 patients (20.77%) and grade 3 in 16 patients (7.73%). In simple regression analysis severity of aortic arch calcification was associated with age (p = 0.032), duration of diabetes (p = 0.026), insulin dependence (p = 0.042) and presence of coronary artery disease (p = 0.039), hypertension (p = 0.019), dyslipidaemia (p = 0.029), retinopathy (p = 0.012) and microalbuminuria (p = 0.01). In multiple regression analysis severity of aortic arch calcification was associated with age (p = 0.04), duration of diabetes (p = 0.032) and presence of hypertension (p = 0.024), dyslipidaemia (p = 0.031) and coronary artery disease (p = 0.04), while the association with retinopathy, microalbuminuria and insulin dependence was no longer significant. Conclusions: Severity of aortic arch calcification is associated with age, diabetes duration, diabetic complications (retinopathy, microalbuminuria), coronary artery disease, insulin dependence, and presence of hypertension and dyslipidaemia.

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Aortic arch calcification is strongly associated with coronary artery calcification

VASA ◽

10.1024/0301-1526/a000415 ◽

2015 ◽

Vol 44 (2) ◽

pp. 106-114 ◽

Cited By ~ 7

Author(s):

Adem Adar ◽

Hakan Erkan ◽

Tayyar Gokdeniz ◽

Aysegul Karadeniz ◽

Ismail G. Cavusoglu ◽

...

Keyword(s):

Coronary Artery ◽

High Risk ◽

Aortic Arch ◽

Chest Radiography ◽

Coronary Artery Calcification ◽

Independent Predictor ◽

Study Group ◽

Discriminative Performance ◽

Sensitivity Specificity ◽

Aortic Arch Calcification

Background: We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low‐ and high‐risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC). Patients and methods: Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64‐slice MDCT scanner for the evaluation of CAC score. A four‐point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior‐anterior chest radiography images. Results: The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of ≥ 2 was the strongest independent predictor of a high‐risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of ≥ 100 (AUC = 0.892, P < 0.0001), and ≥ 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of ≥ 2 predicted a CAC score of ≥400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively. Conclusions: AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low‐ and high‐risk CAC scores.

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