The association between mortality and abdominal aortic calcifi cation and relation between its progression and serum calcium concentration in chronic hemodialysis patients

Title
The association between mortality and abdominal aortic calcifi cation and relation between its progression and serum calcium concentration in chronic hemodialysis patients
Authors
김문재; 이승우; 송준호
Keywords
Abdominal aorta, End-stage renal disease, Hemodialysis, Mortality, Vascular calcification
Issue Date
2014-06
Publisher
KIDNEY RESEARCH AND CLINICAL PRACTICE
Series/Report no.
KIDNEY RESEARCH AND CLINICAL PRACTICE; 33권 2호 pp 95~102
Abstract
Background: The composite summary score (range, 0–24) of abdominal aortic calcification (AAC) devised by Kauppila et al is a simple method of assessing AAC severity. However, few studies have been conducted to determine an optimal AAC cutoff score for the prediction of mortality or to investigate the relation between mineral metabolism and AAC progression using the scoring system. Methods: The medical records of 112 patients on hemodialysis who had undergone simple lateral lumbar radiography every 6 months from August 2009 were reviewed. Patients were followed until November 2012, and the relationship between the degree of AAC at baseline and mortality was evaluated. In addition, the relationship between the progression of AAC and serum concentrations of calcium and phosphate was evaluated in the 75 patients who were successfully followed until November 2012. Results: The mean AAC score at baseline was 5.574.8, and the cutoff calcification score for the prediction of mortality was 7.75 (sensitivity¼61%, specificity¼81%). Patients were allocated to Group A (baseline total calcification score r8.0, n¼85) or Group B (baseline total calcification score48.0, n¼27), and multivariate analysis showed that Group B was an independent risk factor of all-cause mortality and cardiovascular events. Of the 75 patients successfully followed, 51 showed AAC progression (Group 1) and 24 showed no change or improvement (Group 2). Group 1 was found to have significantly higher mean serum corrected calcium levels during the 2nd year and 3rd year of follow-up than Group 2. Furthermore, repeatedmeasures analysis of variance showed higher monthly corrected calcium concentrations (P¼0.099) and mean corrected calcium levels during the 1st year, 2nd year, and 3rd year of follow-up (P¼0.062) in Group 1, but without statistical significance. The cutoff values of mean corrected calcium of the 2nd year and 3rd year for the prediction of AAC progression during follow-up years were 8.96 mg/dL and 9.45 mg/dL, respectively. Serum phosphate levels and corrected calcium phosphate values were similar in Groups 1 and 2. Conclusion: Patients with an AAC score of48 at baseline seem to be at higher risk of mortality during follow-up. Of the serum variables examined, such as corrected calcium, phosphate, and corrected calcium phosphate, corrected calcium was found to be marginally associated with AAC progression. However, a larger-scale prospective study is required to confirm our findings.
URI
http://dspace.inha.ac.kr/handle/10505/38927
ISSN
1975-9460
Appears in Collections:
Medical School/College of Medicine (의학전문대학원/의과대학) > Medical Science (의학) > Local Access Journal Papers, Reports(의학 논문, 보고서)

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