NDT Advance Access originally published online on March 19, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nephrol Dial Transplant (2004) 19: 1480-1488
Nephrol Dial Transplant Vol. 19 No. 6 © ERA-EDTA 2004; all rights reserved
Original Article
A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients
Nefroclinica-Estoril, Rua Vale de S Rita, 19, 2765-293 Esteril, Portugal
Correspondence and offprint requests to: Maria Teresa Pulido Adragao, Nefroclinica-Estoril, Rua Vale de S Rita, 19, 2765-293 Esteril, Portugal. Email: tadragao{at}netcabo.pt
Background. Cardiovascular morbidity and mortality are highly prevalent in haemodialysis (HD) patients and have been recently associated with vascular calcifications. The objective of our study was to assess the value of a simple vascular calcification score for the prediction of cardiovascular death, cardiovascular hospitalizations and fatal and non-fatal cardiovascular events in HD patients, and to correlate this score with cardiovascular disease and with other known predictors of vascular disease.
Methods. In this observational, prospective study 123 chronic HD patients (75 males and 48 females; 20% diabetic) were included, who were on low-flux HD treatment for 46.6±52 months (mean±SD). We set up a simple vascular calcification score based on plain radiographic films of pelvis and hands. Brachial pulse pressure and mean arterial pressure (MAP) were measured and cardiovascular events and hospitalization episodes were assessed.
Results. During an observational period of 37 months there were 17 cardiovascular deaths; 28 patients needed cardiovascular hospitalizations and 32 patients suffered fatal and non-fatal cardiovascular events. Coronary artery disease was diagnosed in 43 patients (35%), peripheral arterial disease in 33 patients (26.8%), cerebrovascular disease in 16 patients (13%) and vascular disease (coronary artery disease or peripheral arterial disease or cerebral vascular disease) in 61 patients (49.6%). By binary logistic regression, diabetes (P = 0.01), male sex (P<0.001), age (P = 0.02), HD duration (P = 0.02) and MAP (P = 0.03) were independently associated with a vascular score 
3. This score 3 was independently associated with coronary artery disease (P = 0.008), peripheral arterial disease (P<0.001) and vascular disease (P = 0.001). Patients with a vascular calcification score 3 had a 3.9-fold higher risk of cardiovascular mortality (P = 0.03), a 2.8-fold higher risk of cardiovascular hospitalizations (P = 0.02) and a 2.3-fold higher risk of fatal or non-fatal cardiovascular events (P = 0.04).
Conclusions. The present vascular calcification scoring represents a simple tool for the assessment of cardiovascular risk related with vascular calcifications in chronic HD patients.
Keywords: haemodialysis; mortality; vascular calcification; vascular disease
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. Adragao, A. Pires, R. Birne, J. D. Curto, C. Lucas, M. Goncalves, and A. P. Negrao A plain X-ray vascular calcification score is associated with arterial stiffness and mortality in dialysis patients Nephrol. Dial. Transplant., March 1, 2009; 24(3): 997 - 1002. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Matias, C. Ferreira, C. Jorge, M. Borges, I. Aires, T. Amaral, C. Gil, J. Cortez, and A. Ferreira 25-Hydroxyvitamin D3, arterial calcifications and cardiovascular risk markers in haemodialysis patients Nephrol. Dial. Transplant., February 1, 2009; 24(2): 611 - 618. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Russo, L. F. Morrone, S. Brancaccio, P. Napolitano, E. Salvatore, R. Spadola, M. Imbriaco, C. V. Russo, and V. E. Andreucci Pulse Pressure and Presence of Coronary Artery Calcification Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 316 - 322. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Bugnicourt, J.-M. Chillon, Z. A Massy, S. Canaple, C. Lamy, H. Deramond, and O. Godefroy High Prevalence of Intracranial Artery Calcification in Stroke Patients with CKD: A Retrospective Study Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 284 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Rodriguez-Garcia, C. Gomez-Alonso, M. Naves-Diaz, J. B. Diaz-Lopez, C. Diaz-Corte, J. B. Cannata-Andia, and the Asturias Study Group Vascular calcifications, vertebral fractures and mortality in haemodialysis patients Nephrol. Dial. Transplant., January 1, 2009; 24(1): 239 - 246. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. H. Criqui, J. K. Ninomiya, D. L. Wingard, M. Ji, and A. Fronek Progression of Peripheral Arterial Disease Predicts Cardiovascular Disease Morbidity and Mortality J. Am. Coll. Cardiol., November 18, 2008; 52(21): 1736 - 1742. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Raggi and M. Kleerekoper Contribution of Bone and Mineral Abnormalities to Cardiovascular Disease in Patients with Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 836 - 843. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ferreira, J. M. Frazao, M.-C. Monier-Faugere, C. Gil, J. Galvao, C. Oliveira, J. Baldaia, I. Rodrigues, C. Santos, S. Ribeiro, et al. Effects of Sevelamer Hydrochloride and Calcium Carbonate on Renal Osteodystrophy in Hemodialysis Patients J. Am. Soc. Nephrol., February 1, 2008; 19(2): 405 - 412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Krasniak, M. Drozdz, M. Pasowicz, G. Chmiel, M. Michalek, D. Szumilak, P. Podolec, P. Klimeczek, M. Konieczynska, E. Wicher-Muniak, et al. Factors involved in vascular calcification and atherosclerosis in maintenance haemodialysis patients Nephrol. Dial. Transplant., February 1, 2007; 22(2): 515 - 521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Ouwendijk, M. C. J. M. Kock, L. C. van Dijk, M. R. H. M. van Sambeek, T. Stijnen, and M. G. M. Hunink Vessel Wall Calcifications at Multi-Detector Row CT Angiography in Patients with Peripheral Arterial Disease: Effect on Clinical Utility and Clinical Predictors Radiology, November 1, 2006; 241(2): 603 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Ayus, M. R. Mizani, S. G. Achinger, R. Thadhani, A. S. Go, and S. Lee Effects of Short Daily versus Conventional Hemodialysis on Left Ventricular Hypertrophy and Inflammatory Markers: A Prospective, Controlled Study J. Am. Soc. Nephrol., September 1, 2005; 16(9): 2778 - 2788. [Abstract] [Full Text] [PDF]
|
|