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. 2011 Oct 15:12:56.
doi: 10.1186/1471-2369-12-56.

Carotid artery calcification at the initiation of hemodialysis is a risk factor for cardiovascular events in patients with end-stage renal disease: a cohort study

Masaru Nakayama  1 , Yoriko Ura, Masaharu Nagata, Yasushi Okada, Yoko Sumida, Kanako Nishida, Hirofumi Ikeda, Yoshiki Kaizu
Affiliations

Carotid artery calcification at the initiation of hemodialysis is a risk factor for cardiovascular events in patients with end-stage renal disease: a cohort study

Masaru Nakayama et al. BMC Nephrol. .

Abstract

Background: Vascular calcification has been recognized as a risk factor for cardiovascular (CV) events in patients with end-stage renal disease (ESRD). However, the association of carotid artery calcification (CAAC) with CV events remains unknown. The aim of this study was to elucidate whether CAAC is associated with composite CV events in ESRD patients.

Methods: One-hundred thirty-three patients who had been started on hemodialysis between 2004 and 2008 were included in this retrospective cohort study. These patients received multi-detector computed tomography to assess CAAC at the initiation of hemodialysis. Composite CV events, including ischemic heart disease, heart failure, cerebrovascular diseases, and CV deaths after the initiation of hemodialysis, were examined in each patient.

Results: CAAC was found in 94 patients (71%). At the end of follow-up, composite CV events were seen in 47 patients: ischemic heart disease in 20, heart failure in 8, cerebrovascular disease in 12, and CV deaths in 7. The incidence of CAAC was 87% in patients with CV events, which was significantly higher than the rate (62%) in those without. Kaplan-Meier analysis showed a significant increase in composite CV events in patients with CAAC compared with those without CAAC (p = 0.001, log-rank test). Univariate analysis using a Cox hazards model showed that age, smoking, common carotid artery intima-media thickness and CAAC were risk factors for composite CV events. In multivariate analysis, only CAAC was a significant risk factor for composite CV events (hazard ratio, 2.85; 95% confidence interval, 1.18-8.00; p = 0.02).

Conclusions: CAAC is an independent risk factor for CV events in ESRD patients. The assessment of CAAC at the initiation of hemodialysis is useful for predicting the prognosis.

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Figures

Figure 1
Figure 1
Carotid artery calcification detected by multi-detector computed tomography at the initiation of hemodialysis was seen at the origin of the bilateral internal carotid arteries and left external carotid artery (arrows).
Figure 2
Figure 2
Kaplan-Meier analysis of the free rate of CV events of 133 patients with end-stage renal disease according to the presence or absence of CAAC. A comparison between the survival curves was significant (p = 0.001, Log-rank test). Abbreviations: CV, cardiovascular; CAAC, carotid artery calcification.
See this image and copyright information in PMC

References

    1. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32(Suppl 3):S112–S119. - PubMed
    1. London GM, Marchais SJ, Guérin AP, Métivier F. Arteriosclerosis, vascular calcifications and cardiovascular disease in uremia. Curr Opin Nephrol Hypertens. 2005;14:525–531. doi: 10.1097/01.mnh.0000168336.67499.c0. - DOI - PubMed
    1. Blacher J, Guérin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension. 2001;38:938–942. doi: 10.1161/hy1001.096358. - DOI - PubMed
    1. London GM, Guérin AP, Marchais SJ, Métivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant. 2003;18:1731–1740. doi: 10.1093/ndt/gfg414. - DOI - PubMed
    1. Matsuoka M, Iseki K, Tamashiro M, Fujimoto N, Higa N, Touma T, Takishita S. Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysis. Clin Exp Nephrol. 2004;8:54–58. doi: 10.1007/s10157-003-0260-0. - DOI - PubMed

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