Skip Navigation


NDT Advance Access originally published online on October 18, 2006
Nephrology Dialysis Transplantation 2007 22(2):508-514; doi:10.1093/ndt/gfl609
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/2/508    most recent
gfl609v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (3)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Muntner, P.
Right arrow Articles by Raggi, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Muntner, P.
Right arrow Articles by Raggi, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Development of a cardiovascular calcification index using simple imaging tools in haemodialysis patients

Paul Muntner1,2, Emiliana Ferramosca3, Antonio Bellasi4, Geoffrey A. Block5 and Paolo Raggi6

1Department of Epidemiology, 2Department of Medicine, Tulane University, New Orleans, LA, USA, 3Department of Nephrology, Ospedale Malpighi and University of Bologna, Bologna, 4Ospedale San Paolo and University of Milan, Milan, Italy, 5Denver Nephrology, PC, Denver, CO, and 6Division of Cardiology, Emory University, Atlanta, GA, USA

Correspondence and offprint requests to: Paul Muntner, PhD, 1140 Canal Street, Suite 2032, New Orleans, LA 70112, USA. Email: pmuntner{at}tulane.edu



  Abstract

Background. Coronary artery calcification (CAC) is highly prevalent in haemodialysis patients and is associated with cardiovascular outcomes. Though cardiac computed tomography (CCT) is accurate, it is not widely available.

Methods. We developed a cardiovascular calcification index (CCI) to predict the presence of CAC for haemodialysis patients using simple in-office techniques. Prevalent haemodialysis patients (n = 140) underwent CCT imaging for CAC, a lateral abdominal X-ray for calcification of the abdominal aorta, an echocardiogram for valvular calcification, and pulse pressure measurement. A CCI was derived by weighting the prevalence rate ratios of CAC ≥1000. Using bootstrap techniques, validation was performed using receiver operator characteristic curves and likelihood ratios.

Results. Points were assigned for patients’ age (60–69 and ≥70 years, 1 and 2 points, respectively), dialysis vintage ≥2 years (1 point), aortic and mitral valve calcification (3 and 1 points, respectively), and abdominal aorta X-ray scores of 1–6 and ≥7 (2 and 4 points, respectively). Race, sex and pulse pressure did not contribute to the CCI. The CCI ranged from 0 to 11 points. The likelihood ratio of CAC ≥1000 associated with CCI scores of 2–4, 5, 6–8 and 9–11 were 1.28, 2.03, 2.94 and 3.83, respectively. Given the prevalence of CAC ≥1000 of 21% in the current study, the probability of having CAC ≥1000 was 26%, 38%, 43% and 50% for participants with CCI scores of 2–4, 5, 6–8, and ≥9, respectively.

Conclusions. Although refinement is needed, the CCI developed in the current study provides an alternative for predicting CAC when CCT is not available.

Keywords: abdominal aorta calcification; arterial stiffness; cardiovascular calcification; haemodialysis; imaging; valvular calcification


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
P. Muntner and P. Raggi
Reply
Nephrol. Dial. Transplant., March 1, 2007; 22(3): 962 - 962.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.