scholarly journals Association of Serum Sclerostin Level, Coronary Artery Calcification, and Patient Outcomes in Maintenance Dialysis Patients

2021 ◽  
pp. 1-10
Author(s):  
Yifei Ge ◽  
Buyun Wu ◽  
Xiangbao Yu ◽  
Ningning Wang ◽  
Xueqiang Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Coronary Artery ◽  
Patient Outcomes ◽  
Coronary Artery Calcification ◽  
Dialysis Patients ◽  
Survival Group ◽  
Dialysis Vintage ◽  
Maintenance Dialysis

<b><i>Objective:</i></b> The objective of this study is to investigate the association between the serum sclerostin, the coronary artery calcification (CAC), and patient outcomes in maintenance dialysis patients. <b><i>Methods:</i></b> We performed a prospective cohort study of 65 maintenance dialysis patients in 2014, including 39 patients on peritoneal dialysis and 26 on hemodialysis, and followed up for 5 years. Parameters of mineral metabolism including bone-specific alkaline phosphatase, fibroblast growth factor 23, sclerostin, and other biochemical factors were determined at the baseline. Meanwhile, the CAC score was analyzed by cardiac computed tomography. <b><i>Results:</i></b> Serum sclerostin in hemodialysis patients was significantly higher than that in peritoneal dialysis patients (632.35 ± 369.18 vs. 228.85 ± 188.92, <i>p</i> &#x3c; 0.001). The patients with CAC were older, receiving hemodialysis, lower Kt/V, and had longer dialysis vintage, as well as higher levels of serum 25-(OH)-vit D and sclerostin. In multivariate logistic regression analysis, older age and lower Kt/V were risk factors for CAC. The area under the receiver operating characteristic curves for prediction of CAC by sclerostin was 0.74 (95% confidence interval 0.605–0.878, <i>p</i> = 0.03), and the cutoff value of sclerostin is 217.55 pg/mL with the sensitivity 0.829 and specificity 0.619. After 5 years of follow-up, 51 patients survived. The patients in the survival group had significantly lower age, sclerostin levels, and low CAC scores than the nonsurvival group. Old age (≥60 years, <i>p</i> &#x3c; 0.001) and high CAC score (≥50 Agatston unit, <i>p</i> = 0.031) were significant risk factors for the patient survival. <b><i>Conclusions:</i></b> Sclerostin is significantly elevated in dialysis patients with CAC. But sclerostin is not a risk factor for CAC. After 5 years of follow-up, patients in the survival group are younger and have lower sclerostin levels and CAC scores. But sclerostin levels are not independent risk factors for high mortality in dialysis patients.

scholarly journals Hyperphosphatemia and hs-CRP Initiate the Coronary Artery Calcification in Peritoneal Dialysis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Da Shang ◽  
Qionghong Xie ◽  
Bin Shang ◽  
Min Zhang ◽  
Li You ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Univariate Analysis ◽  
Density Lipoprotein ◽  
Binary Logistic Regression ◽  
Dialysis Patients ◽  
Independent Risk Factors ◽  
Hs Crp

Background.Coronary artery calcification (CAC) contributes to high risk of cardiocerebrovascular diseases in dialysis patients. However, the risk factors for CAC initiation in peritoneal dialysis (PD) patients are not known clearly.Methods.Adult patients with baseline CaCS = 0 and who were followed up for at least 3 years or until the conversion from absent to any measurable CAC detected were included in this observational cohort study. Binary logistic regression was performed to identify the risk factors for CAC initiation in PD patients.Results.70 patients recruited to our study were split into a noninitiation group (n=37) and an initiation group (n=33) according to the conversion of any measurable CAC during their follow-up or not. In univariate analysis, systolic blood pressure, serum phosphorus, fibrinogen, hs-CRP, serum creatinine, and triglycerides were positively associated with the initiation of CAC, while the high density lipoprotein and nPCR did the opposite function. Multivariate analysis revealed that hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation after adjustments.Conclusions.Hyperphosphatemia and hs-CRP were the independent risk factors for CAC initiation in PD patients. These results suggested potential clinical strategies to prevent the initiation of CAC in PD patients.

scholarly journals Association between Atherogenic Index of Plasma and Coronary Artery Calcification Progression in Korean Adults

2020 ◽  
Author(s):  
Ji Sun Nam ◽  
Min Kyung Kim ◽  
Joo Young Nam ◽  
Kahui Park ◽  
Shinae Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Care Center ◽  
Atherogenic Index ◽  
Cross Sectional ◽  
Atherogenic Index Of Plasma ◽  
Health Care Center ◽  
Korean Adults

Abstract Background Dyslipidemia is a well-known risk factor for cardiovascular disease (CVD). Recently, atherogenic index of plasma (AIP) has been proposed as a novel predictive marker for CVD, and there are few cross sectional studies that demonstrated a relationship between AIP and coronary artery disease. We investigated the association between AIP and the progression of coronary artery calcification (CAC) in Korean adults without CVD. Methods A total of 1,124 participants who had undergone CAC measurement at least twice by multi-detector CT in a health care center were enrolled. Anthropometric profiles and multiple cardiovascular risk factors were assessed. The AIP was defined as the base 10 logarithm of the ratio of the concentration of TG to HDL-C. The CAC progression was defined as either incident CAC in a CAC-free population at baseline or an increase of ≥ 2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACS) among subjects with detectable CAC at baseline Results CAC progression was observed in 290 subjects (25.8%) during the mean 4.2 years of follow-up. All subjects were stratified into three groups according to AIP. There were significant differences in cardiovascular parameters among the groups at baseline. The follow-up CAC and the incidence of CAC progression increased gradually with the rising AIP tertiles. In the logistic regression analysis, the odds ratio for CAC progression was 2.27 when comparing the highest to the lowest tertile of the AIP (95% CI: 1.61-3.19; P for trend <0.01). However, this association was attenuated after adjustment for multiple risk factors (P for trend = 0.67). Conclusions There is a significant correlation between AIP and CAC and its progression in subjects without CVD, but AIP is not an independent predictor of CAC progression.

scholarly journals Atherogenic index of plasma and coronary artery calcification progression beyond traditional risk factors according to baseline coronary artery calcium score

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ki-Bum Won ◽  
Donghee Han ◽  
Ji Hyun Lee ◽  
Su-Yeon Choi ◽  
Eun Ju Chun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcification ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Atherogenic Index ◽  
Atherogenic Index Of Plasma ◽  
Traditional Risk Factors

AbstractThis study aimed to evaluate the association between the atherogenic index of plasma (AIP), which has been suggested as a novel marker for atherosclerosis, and coronary artery calcification (CAC) progression according to the baseline coronary artery calcium score (CACS). We included 12,326 asymptomatic Korean adults who underwent at least two CAC evaluations from December 2012 to August 2016. Participants were stratified into four groups according to AIP quartiles, which were determined by the log of (triglyceride/high-density lipoprotein cholesterol). Baseline CACSs were divided into three groups: 0, 1 − 100, and > 100. CAC progression was defined as a difference ≥ 2.5 between the square roots (√) of the baseline and follow-up CACSs (Δ√transformed CACS). Annualized Δ√transformed CACS was defined as Δ√transformed CACS divided by the inter-scan period. During a mean 3.3-year follow-up period, the overall incidence of CAC progression was 30.6%. The incidences of CAC progression and annualized Δ√transformed CACS were markedly elevated with increasing AIP quartile in participants with baseline CACSs of 0 and 1 − 100, but not in those with a baseline CACS > 100. The AIP level was associated with the annualized Δ√transformed CACS in participants with baseline CACSs of 0 (β = 0.016; P < 0.001) and 1 − 100 (β = 0.035; P < 0.001), but not in those with baseline CACS > 100 (β = 0.032; P = 0.385). After adjusting for traditional risk factors, the AIP was significantly associated with CAC progression in those with baseline CACS ≤ 100. The AIP has value for predicting CAC progression in asymptomatic adults without heavy baseline CAC.

P1290RISK FACTORS FOR PROGRESSION OF CORONARY ARTERY CALCIFICATION OVER 5 YEARS IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ahmed Alayoud ◽  
Azizi Mounia ◽  
Jabrane Marouan ◽  
Mohammed Arrayhani
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Strong Association ◽  
Dialysis Dose ◽  
Male Sex ◽  
Stage Renal Disease ◽  
End Stage ◽  
Important Marker

Abstract Background Although progression of coronary artery calcification (CAC) has been established as an important marker for cardiovascular morbidity, very few studies have studied it in end-stage renal disease patients. Thus we examined and evaluate risk factors of calcification changes in dialysis patients. Method Among 28 hemodialysis (HD) patients, CAC was measured in Agatston units at baseline and after five years using the 64 multi-slice ultra-fast CT. The HD patients were classified as progressors or no progressors according to the change in the CAC score across these 2 measurements. Results Over an average 63 months follow-up, participants without CAC at baseline had no incident CAC .The progression of CAC was slow and was found only in 6 patients (21.4%) . It was significantly associated with several cardiovascular risk factors, namely, older age (p=0.03), diabetes (p=0.05), male sex (p=0.02), hypercholesterolemia (p = 0.05), anemia (p=0.017), inflammation (p=0.05), and hyperphosphataemia (p=0.012) . However, calcemia, parathormone levels, dialysis duration, tobacco, high blood pressure and dialysis dose did not seem to influence the progression of CAC in our series. A strong association was found between basal calcification scores and Delta increment at 5 years. Conclusions Our study suggests that CAC progression in dialysis is a complex phenomenon, associated with several risk factors with special regard to elevated basal scores. This progression can be avoided or slowed with appropriate management which must begin in the early stages of chronic kidney disease

Abstract P370: Risk Factors for Progression of Coronary Artery Calcification in Patients with Chronic Kidney Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Joshua D Bundy ◽  
Lawrence J Appel ◽  
Matthew Budoff ◽  
Jing Chen ◽  
Alan S Go ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Cystatin C ◽  
Coronary Artery Calcification ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk

Introduction: Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and predicts the risk of cardiovascular disease (CVD). Risk factors for the progression of CAC in patients with CKD have not been well studied. Hypothesis: We assessed the hypothesis that several established and novel CVD risk factors are associated with progression of CAC among patients with CKD. Methods: In a random subsample of 1,123 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study, CAC was measured at baseline and the follow-up visit using electron beam computed tomography (CT) or multidetector CT. CAC progression was defined as an increase of Agatston score ≥100 units during follow-up. Multiple logistic regression and mixed-effects regression models were used to assess risk factors for progression of CAC. Results: Over an average of 3-year follow-up, 332 (29.6%) participants developed CAC progression. After adjusting for age, sex, race, clinical site, total cholesterol, HDL-cholesterol, systolic blood pressure, antihypertensive treatment, diabetes, and current smoking in the multivariable models, history of CVD (odds ratio [OR] 1.53, 95% CI 1.09-2.15, p=0.02), lipid-lowering treatment (OR 1.81, 95% CI 1.28-2.55, p<0.001), higher serum phosphate (OR 1.37, 95% CI 1.17-1.61, p<0.001), hemoglobin A1c (OR 1.32, 95% CI 1.10-1.58, p=0.002), and cystatin C (OR 1.24, 95% CI 1.06-1.45, p=0.007), and lower estimated-glomerular filtration rate (eGFR) (OR 1.32, 95% CI 1.10-1.56, p=0.002) were associated with CAC progression. In addition, lower physical activity, lipid-lowering treatment, body-mass index, LDL-cholesterol, lower serum calcium, phosphate, total parathyroid hormone, fibrinogen, interleukin-6, tumor necrosis factor-α, fibroblast growth factor-23, lower eGFR, cystatin C, and 24-hour urine albumin were associated with square root transformed change in CAC score from baseline in multiple-adjusted models. These findings persisted after additional adjustment for baseline CAC score. Conclusions: In conclusion, these data suggest that reduced kidney function, calcium and phosphate metabolic disorders and inflammation, in addition to established CVD risk factors, might play a role in CAC progression among patients with CKD.

scholarly journals The Relationship between Epicardial Adipose Tissue and Coronary Artery Calcification in Peritoneal Dialysis Patients

2012 ◽  
Vol 2 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Kultigin Turkmen ◽  
Orhan Ozbek ◽  
Hatice Kayikcioğlu ◽  
Mehmet Kayrak ◽  
Yalcin Solak ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Peritoneal Dialysis ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Epicardial Adipose Tissue ◽  
Dialysis Patients ◽  
The Relationship

scholarly journals Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

2015 ◽  
Vol 35 (2) ◽  
pp. 206-215 ◽  
Author(s):  
Hong Xu ◽  
Makoto Watanabe ◽  
Abdul Rashid Qureshi ◽  
Olof Heimbürger ◽  
Peter Bárány ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Body Mass ◽  
Dialysis Modality ◽  
Dialysis Patients ◽  
Comorbidity Score ◽  
Dialysis Vintage ◽  
All Cause Mortality

Background and Aims Increased oxidative stress in dialysis patients is thought to contribute to increased mortality; however, confirmatory data are scarce. We analyzed the serum concentration of 8-hydroxy-2'–deoxyguanosine (8-OHdG), a marker of oxidative stress, in relation to mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods Serum 8-OHdG, interleukin 6 (IL-6), other biochemical markers, Davies comorbidity score, and protein-energy wasting (PEW) were assessed in 303 prevalent patients treated with HD (n = 220; age: 63 ± 14 years) or PD (n = 83; age: 64 ± 14 years). Mortality was assessed after a median follow-up of 31 months. Results The median (25th - 75th percentile) concentration of 8-OHdG was higher in HD than in PD patients: 1.3 ng/mL (0.9 - 1.8 ng/mL) versus 0.5 ng/mL (0.4 - 0.6 ng/mL), p < 0.001. The HD modality (standard β = 0.57, p < 0.001) and dialysis vintage (standard β3 = 0.12, p = 0.02) were independent predictors of serum 8-OHdG in a multivariable linear regression model including age, sex, body mass index, dialysis modality (HD or PD), preceding time on dialysis (dialysis vintage), PEW, comorbidity score, IL-6, and use of angiotensin converting-enzyme inhibitors or angiotensin II receptor blockers or statins. During follow-up, 107 patients died. In multivariable Cox regression models including all 303 patients and adjusted for age, sex, body mass index, dialysis modality, dialysis vintage, and comorbidity score, 8-OHdG was significantly associated with all-cause mortality (adjusted hazard ratio: 1.40; 95% confidence limits: 1.05, 1.87 for 1 standard deviation increase of 8-OHdG). In subgroup analyses according to dialysis modality, 8-OHdG was associated with mortality in HD patients but not in PD patients. Conclusions Oxidative stress as assessed by 8-OHdG is an independent predictor of all-cause mortality in dialysis patients. This association was seen in HD patients, but no such association could be demonstrated for PD patients.

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