The progression and impact of vascular calcification in peritoneal dialysis patients

The progression and impact of vascular calcification in peritoneal dialysis patients

Author Ammirati, Adriano Luiz Autor UNIFESP Google Scholar
Dalboni, Maria Aparecida Autor UNIFESP Google Scholar
Cendoroglo Neto, Miguel Autor UNIFESP Google Scholar
Draibe, Sergio Antonio Autor UNIFESP Google Scholar
Santos, Raul Dias dos Google Scholar
Miname, Marcio Hiroshi Google Scholar
Canziani, Maria Eugênia Fernandes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract Background. Progression of coronary artery calcification (CAC) has been described in hemodialysis patients, and severe CAC has been associated with the occurrence of cardiovascular events in this population. Little information is available regarding peritoneal patients.Aim: To prospectively evaluate peritoneal dialysis patients in order to identify the variables associated with the rate of CAC progression, as well as to determine the impact that baseline CAC has on clinical outcomes over a 1-year follow-up period.Methods: Using multislice coronary tomography, calcium scores were estimated at baseline and after 12 months in 49 peritoneal dialysis patients. Patients with and without CAC progression were compared with respect to clinical characteristics and biochemical variables, including lipid profile, parameters of mineral metabolism, and markers of inflammation. Cardiovascular events, hospitalizations, and att-cause mortality were recorded.Results: At baseline, 29 patients (59%) presented CAC and a median calcium score of 234.7 (range 10.3 - 2351) Agatston units. Progression of CAC was observed in 13 patients (43%) who, in comparison with those presenting no CAC progression, were older, presented higher baseline calcium scores, and had higher mean glucose levels, lower mean high density lipoprotein cholesterol levels, and more months using low calcium peritoneal solution. We also observed a trend toward more often presenting with a history of hypertension, exhibiting more hyperphosphatemic and hyperglycemic events, and having lower albumin levels. In multiple logistic regression, only baseline calcium score was independently associated with progression of CAC. A shorter cardiovascular event-free time and a trend toward lower survival rates were observed in the group with CAC. Hospitalization event-free time did not differ between the groups.Conclusion: Determining CAC provides important prognostic data in peritoneal dialysis patients. Baseline calcium score and disturbances in glucose, mineral, and lipid metabolism were indicative of higher risk of CAC progression in this population.
Keywords vascular calcification
mortality
cardiovascular disease
atherosclerosis
coronary tomography
inflammation
mineral metabolism
Language English
Date 2007-05-01
Published in Peritoneal Dialysis International. Toronto: Multimed Inc, v. 27, n. 3, p. 340-346, 2007.
ISSN 0896-8608 (Sherpa/Romeo, impact factor)
Publisher Multimed Inc
Extent 340-346
Origin http://www.pdiconnect.com/content/27/3/340.abstract
Access rights Closed access
Type Article
Web of Science ID WOS:000247505800025
URI http://repositorio.unifesp.br/11600/45081

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