Vascular Calcification in Patients with Nondialysis CKD over 3 Years
| Autor: | Rocío Vila, Guillermina Barril, Verónica Escudero, M. Jesús Cerverón, José Luis Górriz, Luis M. Molinero, Teresa Adragão, Juan F. Navarro-González, Luis M Pallardó, Sophie A. Jamal, Elvira Fernández, Cristina Castro-Alonso, Javier Nieto, Jordi Bover, Celestino Piñera, Alberto Martínez-Castelao, Pablo Molina |
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| Rok vydání: | 2015 |
| Předmět: |
Transplantation
medicine.medical_specialty Epidemiology business.industry Proportional hazards model medicine.medical_treatment Hazard ratio Odds ratio Critical Care and Intensive Care Medicine Confidence interval Surgery Nephrology Predictive value of tests Internal medicine Medicine business Prospective cohort study Survival analysis Dialysis |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 10:654-666 |
| ISSN: | 1555-9041 |
| DOI: | 10.2215/cjn.07450714 |
| Popis: | Background and objectives Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed. Design, setting, participants, & measurements The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3–5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models. Results VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P 6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event–free period (HR, 1.14; 95% CI, 1.06 to 1.22; P Conclusions VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful index to identify patients with CKD at high risk of death and morbidity as previously reported in patients on dialysis. |
| Databáze: | OpenAIRE |
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