BACKGROUND: Cardiovascular calcification (CVC) is common and severe in patients with end-stage renal disease on dialysis. However, the prevalence and severity of CVC is less well documented in patients with chronic kidney disease (CKD) not yet on dialysis. METHODS: Fifty-eight nondialyzed HA with type 2 diabetes and CKD were enrolled. They comprise 29 patients with stages 1 and 2 CKD (early CKD group) and 26 patients with stages 4 and 5 CKD (advanced CKD group). Coronary artery calcification (CAC) was measured by ultrafast spiral computed tomography, while peripheral artery calcification (PAC) was evaluated by plain x-ray of the chest, pelvis, thighs, and lower extremities. RESULTS: The prevalence of CAC and PAC were significantly higher in the advanced CKD group compared to the early CKD group (73% vs. 38%; P < 0.01 and 85% vs. 35%; P < 0.0001, respectively). The median CAC scores were 18-fold greater in the advanced CKD group (138.9 vs. 7.8, respectively). By linear regression analysis, a strong association was found between the level of renal function and ln total volume of CAC. CONCLUSION: Our data indicate that CAC and PAC are common and severe in HA diabetic patients with CKD not previously treated with dialysis, calcium-based phosphate binders, or vitamin D analogues. Lower level of renal function is associated with increased burden of vascular calcification in predialysis patients with CKD.
BACKGROUND:Cardiovascular calcification (CVC) is common and severe in patients with end-stage renal disease on dialysis. However, the prevalence and severity of CVC is less well documented in patients with chronic kidney disease (CKD) not yet on dialysis. METHODS: Fifty-eight nondialyzed HA with type 2 diabetes and CKD were enrolled. They comprise 29 patients with stages 1 and 2 CKD (early CKD group) and 26 patients with stages 4 and 5 CKD (advanced CKD group). Coronary artery calcification (CAC) was measured by ultrafast spiral computed tomography, while peripheral artery calcification (PAC) was evaluated by plain x-ray of the chest, pelvis, thighs, and lower extremities. RESULTS: The prevalence of CAC and PAC were significantly higher in the advanced CKD group compared to the early CKD group (73% vs. 38%; P < 0.01 and 85% vs. 35%; P < 0.0001, respectively). The median CAC scores were 18-fold greater in the advanced CKD group (138.9 vs. 7.8, respectively). By linear regression analysis, a strong association was found between the level of renal function and ln total volume of CAC. CONCLUSION: Our data indicate that CAC and PAC are common and severe in HA diabeticpatients with CKD not previously treated with dialysis, calcium-based phosphate binders, or vitamin D analogues. Lower level of renal function is associated with increased burden of vascular calcification in predialysis patients with CKD.
Authors: Alan A Sag; Adrian Covic; Gerard London; Marc Vervloet; David Goldsmith; Jose Luis Gorriz; Mehmet Kanbay Journal: Int Urol Nephrol Date: 2016-02-22 Impact factor: 2.370
Authors: Bryan R Kestenbaum; Kathryn L Adeney; Ian H de Boer; Joachim H Ix; Michael G Shlipak; David S Siscovick Journal: Kidney Int Date: 2009-08-19 Impact factor: 10.612
Authors: Joachim H Ix; Ronit Katz; Bryan Kestenbaum; Linda F Fried; Holly Kramer; Catherine Stehman-Breen; Michael G Shlipak Journal: J Am Soc Nephrol Date: 2008-01-30 Impact factor: 10.121
Authors: Benjamin D Parker; Joachim H Ix; Ellen C M Cranenburg; Cees Vermeer; Mary A Whooley; Leon J Schurgers Journal: Nephrol Dial Transplant Date: 2009-02-09 Impact factor: 5.992