Zhi-Hong Liu1, Xue-Qing Yu2, Jun-Wei Yang3, Ai-Li Jiang4, Bi-Cheng Liu5, Chang-Ying Xing6, Ji-Zhuang Lou7, Mei Wang8, Hong Cheng9, Jun Liu10, Jun-Zhou Fu11, Ai-Hua Zhang12, Miao Zhang13, Qiao-Ling Zhou14, Chen Yu15, Rong Wang16, Li Wang17, Yu-Qing Chen18, Tian-Jun Guan19, Ai Peng20, Nan Chen21, Chuan-Ming Hao22, Xu-Yang Cheng23. 1. a Department of Nephrology , National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine , Nanjing , PR China. 2. b Department of Nephrology , The First Affiliated Hospital of Sun Yat-sen University , Guangzhou , PR China. 3. c Center of Kidney Disease , The Second Affiliated Hospital of Nanjing Medical University , Nanjing , PR China. 4. d Department of Kidney Disease and Blood Purification , The Second Hospital of Tianjin Medical University , Tianjin , PR China. 5. e Institute of Nephrology , Zhongda Hospital of Southeast University , Nanjing , PR China. 6. f Department of Nephrology , First Affiliated Hospital of Nanjing Medical University , Nanjing , PR China. 7. g Department of Nephrology , Nanjing First Hospital , Nanjing , PR China. 8. h Department of Nephrology , Peking University People's Hospital , Beijing , PR China. 9. i Department of Nephrology , Beijing Anzhen Hospital , Beijing , PR China. 10. j Department of Nephrology , Southern Medical University Nanfang Hospital , Guangzhou , PR China. 11. k Department of Nephrology , Guangzhou First People's Hospital , Guangzhou , PR China. 12. l Department of Nephrology , Third Hospital of Peking University , Beijing , PR China. 13. m Department of Nephrology , Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital , Nanjing , PR China. 14. n Department of Nephrology , Xiangya Hospital of Central South University , Changsha , PR China. 15. o Department of Nephrology , Shanghai Tongji Hospital , Shanghai , PR China. 16. p Department of Nephrology , Shandong Provincial Hospital , Jinan , PR China. 17. q Department of Nephrology , Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital , Chengdu , PR China. 18. r Renal Division, Department of Medicine , Peking University First Hospital , Beijing , PR China. 19. s Department of Nephrology , Zhongshan Hospital Xiamen University , Xiamen , PR China. 20. t Department of Nephrology , Shanghai Tenth People's Hospital , Shanghai , PR China. 21. u Department of Nephrology , Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , PR China. 22. v Department of Nephrology , Huashan Hospital, Fudan University , Shanghai , PR China. 23. w Renal Division, Department of Medicine , Peking University First Hospital , Beijing , PR China.
Abstract
OBJECTIVE: With limited data available on calcification prevalence in chronic kidney disease (CKD) patients on dialysis, the China Dialysis Calcification Study (CDCS) determined the prevalence of vascular/valvular calcification (VC) and association of risk factors in Chinese patients with prevalent hemodialysis (HD) or peritoneal dialysis (PD). METHODS: CKD patients undergoing HD/PD for ≥6 months were enrolled. Prevalence data for calcification and medical history were documented at baseline. Coronary artery calcification (CAC) was assessed by electron beam or multi-slice computed tomography (EBCT/MSCT), abdominal aortic calcification (AAC) by lateral lumbar radiography, and cardiac valvular calcification (ValvC) by echocardiography. Serum phosphorus, calcium, intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D and FGF-23 were evaluated. A logistic regression model was used to evaluate the association between risk factors and VC. RESULTS: Of 1,497 patients, 1,493 (78.3% HD, 21.7% PD) had ≥1 baseline calcification image (final analysis cohort, FAC) and 1,423 (78.8% HD, 21.2% PD) had baseline calcification data complete (BCDC). Prevalence of VC was 77.4% in FAC (80.8% HD, 65.1% PD, p < .001) and 77.5% in BCDC (80.7% HD, 65.8% PD). The proportion of BCDC patients with single-site calcification were 20% for CAC, 4.3% for AAC, and 4.3% for cardiac valvular calcification (ValvC), respectively. Double site calcifications were 23.4% for CAC and AAC, 6.5% for CAC and ValvC, and 1.1% for AAC and ValvC, respectively. In total, 17.9% patients had calcification at all three sites. CONCLUSIONS: High prevalence of total VC in Chinese CKD patients will supplement current knowledge, which is mostly limited, contributing in creating awareness and optimizing VC management.
OBJECTIVE: With limited data available on calcification prevalence in chronic kidney disease (CKD) patients on dialysis, the China Dialysis Calcification Study (CDCS) determined the prevalence of vascular/valvular calcification (VC) and association of risk factors in Chinese patients with prevalent hemodialysis (HD) or peritoneal dialysis (PD). METHODS:CKDpatients undergoing HD/PD for ≥6 months were enrolled. Prevalence data for calcification and medical history were documented at baseline. Coronary artery calcification (CAC) was assessed by electron beam or multi-slice computed tomography (EBCT/MSCT), abdominal aortic calcification (AAC) by lateral lumbar radiography, and cardiac valvular calcification (ValvC) by echocardiography. Serum phosphorus, calcium, intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D and FGF-23 were evaluated. A logistic regression model was used to evaluate the association between risk factors and VC. RESULTS: Of 1,497 patients, 1,493 (78.3% HD, 21.7% PD) had ≥1 baseline calcification image (final analysis cohort, FAC) and 1,423 (78.8% HD, 21.2% PD) had baseline calcification data complete (BCDC). Prevalence of VC was 77.4% in FAC (80.8% HD, 65.1% PD, p < .001) and 77.5% in BCDC (80.7% HD, 65.8% PD). The proportion of BCDC patients with single-site calcification were 20% for CAC, 4.3% for AAC, and 4.3% for cardiac valvular calcification (ValvC), respectively. Double site calcifications were 23.4% for CAC and AAC, 6.5% for CAC and ValvC, and 1.1% for AAC and ValvC, respectively. In total, 17.9% patients had calcification at all three sites. CONCLUSIONS: High prevalence of total VC in Chinese CKDpatients will supplement current knowledge, which is mostly limited, contributing in creating awareness and optimizing VC management.
Authors: Yenny Kandarini; Gede Wira Mahadita; Sianny Herawati; Ida Bagus Rangga Wibhuti; I Gde Raka Widiana; Nyoman Paramita Ayu Journal: Int J Gen Med Date: 2022-04-20
Authors: Jia Shi; Yi Yang; Ya-Nan Wang; Qing Li; Xue Xing; An-Ying Cheng; Xiao-Na Zhan; Jie Li; Gang Xu; Fan He Journal: Cell Death Dis Date: 2022-03-11 Impact factor: 8.469