Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Feb;5(2):189-94.
doi: 10.2215/CJN.06240909. Epub 2009 Dec 3.

Impact of cardiovascular calcification in nondialyzed patients after 24 months of follow-up

Renato Watanabe  1 , Marcelo M Lemos, Silvia R Manfredi, Sérgio A Draibe, Maria Eugênia F Canziani
Affiliations

Impact of cardiovascular calcification in nondialyzed patients after 24 months of follow-up

Renato Watanabe et al. Clin J Am Soc Nephrol. 2010 Feb.

Abstract

Background and objectives: Coronary artery calcification (CAC) is highly prevalent among patients with chronic kidney disease (CKD), and it has been described as a strong predictor of mortality in the dialysis population. Because there is a lack of information regarding cardiovascular calcification and clinical outcomes in the earlier stages of the disease, we aimed to evaluate the impact of CAC on cardiovascular events, hospitalization, and mortality in nondialyzed patients with CKD.

Design, setting, participants, & measurements: This is a prospective study including 117 nondialyzed patients with CKD (age, 57 +/- 11.2 years; 61% male; 23% diabetics; creatinine clearance, 36.6 +/- 17.8 ml/min per 1.73 m(2)). CAC was quantified by multislice computed tomography. The occurrence of cardiovascular events, hospitalization, and death was recorded over 24 months.

Results: CAC >10 Agatston units (AU) was observed in 48% of the patients [334 (108 to 858.5) AU; median (interquartiles)], and calcification score >or=400 AU was found in 21% [873 (436-2500) AU]. During the follow-up, the occurrence of 15 cardiovascular events, 19 hospitalizations, and 4 deaths was registered. The presence of CAC >10 AU was associated with shorter hospitalization event-free time and lower survival. CAC >or=400 AU was additionally associated with shorter cardiovascular event-free time. Adjusting for age and diabetes, CAC >or=400 AU was independently associated with the occurrence of hospitalization and cardiovascular events.

Conclusions: Cardiovascular events, hospitalization, and mortality were associated with the presence of CAC in nondialyzed patients with CKD. Severe CAC was a predictor of cardiovascular events and hospitalization in these patients.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Proportion of patients with CAC score >10 and ≥400 AU according to the stages of CKD (170 × 127 mm; 300 × 300 DPI).
Figure 2.
Figure 2.
Cardiovascular event-free (A), hospitalization event-free (B), and survival (C) periods in 117 nondialyzed patients with CKD according to the presence of CAC score ≤10 or 10 AU (170 × 127 mm; 300 × 300 DPI).
Figure 3.
Figure 3.
Cardiovascular event-free (A), hospitalization event-free (B), and survival (C) periods in 117 nondialyzed patients with CKD according to the presence of CAC score <400 or ≥400 AU (170 × 127 mm; 300 × 300 DPI).
See this image and copyright information in PMC

References

    1. Foley RN, Parfrey PS, Sarnay MJ: Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 9: s16–s23, 1998 - PubMed
    1. Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB: Coronary artery calcification in young adults with end stage renal disease who are undergoing dialysis. N Engl J Med 342: 1478–1483, 2000 - PubMed
    1. Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke S, Chertow GM: Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol 39: 695–701, 2002 - PubMed
    1. Floege J, Ketteler M: Vascular calcification in patients with end-stage renal disease. Nephrol Dial Transplant 19 [Suppl 5]: v59–v66, 2004 - PubMed
    1. Block GA, Raggi P, Bellasi A, Kooienga L, Spiegel DM: Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int 71: 438–441, 2007 - PubMed

MeSH terms