Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients
| Autor: | Mai Ots-Rosenberg, Maria Svensson, Henrik Hadimeri, Maija Heiro, Johan V. Povlsen, Satu Mäkelä, Jana Uhlinova, Heini Huhtala, Leena Kauppila, Heikki Saha, Susanne Ljungman, Björn Rogland, James G. Heaf, Maarit Vainiotalo, Markku Asola, Petra Roessel |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Arterial disease Finland/epidemiology Denmark medicine.medical_treatment Vascular Calcifications 030232 urology & nephrology Vascular Calcification/diagnosis 030204 cardiovascular system & hematology 0302 clinical medicine Risk Factors Cause of Death Aortic calcifications Aorta Abdominal Prospective Studies Finland Vascular calcification Survival Rate/trends Incidence Estonia/epidemiology General Medicine Middle Aged Prognosis All-cause mortality Survival Rate Ankle-brachial index Nephrology Cardiology Female Peritoneal Dialysis Estonia medicine.medical_specialty Peritoneal Dialysis/adverse effects Critical Illness Peritoneal dialysis Aortic Diseases Cause of Death/trends Dialysis patients 03 medical and health sciences Renal Dialysis Internal medicine Aortic Diseases/diagnosis Peripheral arterial disease medicine Humans Ankle Brachial Index Vascular Calcification Sweden business.industry Abdominal aortic calcification score Aorta Abdominal/diagnostic imaging Ultrasonography Doppler ta3121 Denmark/epidemiology Critical Illness/mortality Sweden/epidemiology business All cause mortality |
| Zdroj: | Mäkelä, S M, Asola, M, Hadimeri, H, Heaf, J G, Heiro, M, Kauppila, L, Ljungman, S, Ots-Rosenberg, M, Povlsen, J V, Rogland, B, Roessel, P, Uhlinova, J, Vainiotalo, M, Svensson, M K, Huhtala, H & Saha, H 2018, ' Abdominal aortic calcifications predict survival in peritoneal dialysis patients ', Peritoneal Dialysis International, vol. 38, no. 5, pp. 366-373 . https://doi.org/10.3747/pdi.2017.00043 Mäkelä, S, Asola, M, Hadimeri, H, Heaf, J, Heiro, M, Kauppila, L, Ljungman, S, Ots-Rosenberg, M, Povlsen, J V, Rogland, B, Roessel, P, Uhlinova, J, Vainiotalo, M, Svensson, M K, Huhtala, H & Saha, H 2018, ' Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients ', Peritoneal Dialysis International, vol. 38, no. 5, pp. 366-373 . https://doi.org/10.3747/pdi.2017.00043 |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.3747/pdi.2017.00043 |
| Popis: | BackgroundPeripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.MethodsWe enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar X ray, and the ankle-brachial index (ABI) using a Doppler device.ResultsThe median AACS was 11 (range 0 – 24). In 58% of the patients, all 4 segments of the abdominal aorta showed deposits, while 19% of patients had no visible deposits (AACS 0). Ankle-brachial index was normal in 49%, low (< 0.9) in 17%, and high (> 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS ≥ 7 ( p < 0.001). The adjusted hazard ratio for all-cause mortality was 4.85 (95% confidence interval [CI] 1.94 – 24.46) for aortic calcification (AACS ≥ 7), 2.14 for diabetes (yes/no), 0.93 for albumin (per 1 g/L), and 1.04 for age (per year). A low or high ABI were not independently associated with mortality.ConclusionsSevere aortic calcification was a strong predictor of all-cause mortality in PD patients. The evaluation of aortic calcifications by lateral X ray is a simple method that allows the identification of high-risk patients. |
| Databáze: | OpenAIRE |
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