Wei Chen1, Jessica Fitzpatrick2, Jose M Monroy-Trujillo3, Stephen M Sozio4, Bernard G Jaar5, Michelle M Estrella6, Jishyra Serrano7, Viktoriya Anokhina8, Benjamin L Miller9, Michal L Melamed10, David A Bushinsky7, Rulan S Parekh11. 1. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. Electronic address: weichen@montefiore.org. 2. Department of Medicine and Pediatrics, University of Toronto, Toronto, Ontario, Canada. 3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 4. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD. 5. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD; Nephrology Center of Maryland, Baltimore, MD. 6. Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, CA; San Francisco VA Health Care System, San Francisco, CA. 7. Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. 8. Departments of Biochemistry and Biophysics, University of Rochester School of Medicine and Dentistry, Rochester, NY. 9. Departments of Biochemistry and Biophysics, University of Rochester School of Medicine and Dentistry, Rochester, NY; Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY; Biomedical Engineering, University of Rochester School of Medicine and Dentistry, Rochester, NY. 10. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. 11. Department of Medicine and Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD.
Abstract
RATIONALE & OBJECTIVE: Characteristics of the transformation of primary to secondary calciprotein particles (CPPs) in serum, including the size of secondary CPP (CPP2) aggregates and the time of transformation (T50), may be markers for arterial calcification in patients undergoing hemodialysis (HD). We examined the associations of CPP2 aggregate size and T50 with arterial calcification in incident HD patients. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Incident HD patients (n=402with available CPP2 measures and n=388with available T50 measures) from the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) Study PREDICTORS: Serum CPP2 size and T50 at baseline. OUTCOMES: Primary outcomes were baseline coronary artery and thoracic aorta calcifications. Exploratory outcomes included baseline arterial stiffness, measured by pulse wave velocity (PWV) and ankle brachial index, and longitudinally, repeat measures of PWV and all-cause mortality. ANALYTICAL APPROACH: Tobit regression, multiple linear regression, Poisson regression, linear mixed-effects regression, and Cox proportional hazards regression. RESULTS: Mean age was 55±13 years, 41% were women, 71% were Black, and 57% had diabetes mellitus. Baseline CPP2 size and T50 were correlated with baseline fetuin A level (r=-0.59 for CPP2 and 0.44 for T50; P<0.001 for both), but neither was associated with baseline measures of arterial calcification or arterial stiffness. Baseline CPP2 size and T50 were not associated with repeat measures of PWV. During a median follow-up of 3.5 (IQR, 1.7-6.2) years, larger CPP2 was associated with higher risk for mortality (HR, 1.17 [95% CI, 1.05-1.31] per 100nm larger CPP2 size) after adjusting for demographics and comorbid conditions, but there was no association between baseline T50 and risk for mortality. LIMITATIONS: Possible imprecision in assays, small sample size, limited generalizability to incident HD populations with different racial composition, and residual confounding. CONCLUSIONS: In incident HD patients, neither CPP2 size nor T50 was associated with prevalent arterial calcification and stiffness. Larger CPP2 was associated with risk for mortality, but this finding needs to be confirmed in future studies.
RATIONALE & OBJECTIVE: Characteristics of the transformation of primary to secondary calciprotein particles (CPPs) in serum, including the size of secondary CPP (CPP2) aggregates and the time of transformation (T50), may be markers for arterial calcification in patients undergoing hemodialysis (HD). We examined the associations of CPP2 aggregate size and T50 with arterial calcification in incident HD patients. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Incident HD patients (n=402with available CPP2 measures and n=388with available T50 measures) from the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) Study PREDICTORS: Serum CPP2 size and T50 at baseline. OUTCOMES: Primary outcomes were baseline coronary artery and thoracic aorta calcifications. Exploratory outcomes included baseline arterial stiffness, measured by pulse wave velocity (PWV) and ankle brachial index, and longitudinally, repeat measures of PWV and all-cause mortality. ANALYTICAL APPROACH: Tobit regression, multiple linear regression, Poisson regression, linear mixed-effects regression, and Cox proportional hazards regression. RESULTS: Mean age was 55±13 years, 41% were women, 71% were Black, and 57% had diabetes mellitus. Baseline CPP2 size and T50 were correlated with baseline fetuin A level (r=-0.59 for CPP2 and 0.44 for T50; P<0.001 for both), but neither was associated with baseline measures of arterial calcification or arterial stiffness. Baseline CPP2 size and T50 were not associated with repeat measures of PWV. During a median follow-up of 3.5 (IQR, 1.7-6.2) years, larger CPP2 was associated with higher risk for mortality (HR, 1.17 [95% CI, 1.05-1.31] per 100nm larger CPP2 size) after adjusting for demographics and comorbid conditions, but there was no association between baseline T50 and risk for mortality. LIMITATIONS: Possible imprecision in assays, small sample size, limited generalizability to incident HD populations with different racial composition, and residual confounding. CONCLUSIONS: In incident HD patients, neither CPP2 size nor T50 was associated with prevalent arterial calcification and stiffness. Larger CPP2 was associated with risk for mortality, but this finding needs to be confirmed in future studies.
Authors: Wei Chen; Viktoriya Anokhina; Gregory Dieudonne; Matthew K Abramowitz; Randeep Kashyap; Chen Yan; Tong Tong Wu; Karen L de Mesy Bentley; Benjamin L Miller; David A Bushinsky Journal: Nephrol Dial Transplant Date: 2019-06-01 Impact factor: 5.992
Authors: José L Górriz; Pablo Molina; M Jesús Cerverón; Rocío Vila; Jordi Bover; Javier Nieto; Guillermina Barril; Alberto Martínez-Castelao; Elvira Fernández; Verónica Escudero; Celestino Piñera; Teresa Adragao; Juan F Navarro-Gonzalez; Luis M Molinero; Cristina Castro-Alonso; Luis M Pallardó; Sophie A Jamal Journal: Clin J Am Soc Nephrol Date: 2015-03-13 Impact factor: 8.237
Authors: Marietta Herrmann; Cora Schäfer; Alexander Heiss; Steffen Gräber; Anne Kinkeldey; Andrea Büscher; Martin M N Schmitt; Jörg Bornemann; Falk Nimmerjahn; Martin Herrmann; Laura Helming; Siamon Gordon; Willi Jahnen-Dechent Journal: Circ Res Date: 2012-07-02 Impact factor: 17.367
Authors: Andreas Pasch; Geoffrey A Block; Matthias Bachtler; Edward R Smith; Wilhelm Jahnen-Dechent; Spyridon Arampatzis; Glenn M Chertow; Patrick Parfrey; Xiaoye Ma; Juergen Floege Journal: Clin J Am Soc Nephrol Date: 2016-12-09 Impact factor: 8.237
Authors: Andy I Choi; Rudolph A Rodriguez; Peter Bacchetti; Daniel Bertenthal; German T Hernandez; Ann M O'Hare Journal: Am J Med Date: 2009-07 Impact factor: 4.965
Authors: Mark K Tiong; Michael M X Cai; Nigel D Toussaint; Sven-Jean Tan; Andreas Pasch; Edward R Smith Journal: Sci Rep Date: 2022-05-05 Impact factor: 4.996