A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients

Adragão, Teresa; Pires, Ana; Lucas, Carlos; Birne, Rita; Magalhães, L. P.; Gonçalves, Margarida; Negrão, Acácio Pita

doi:10.1093/ndt/gfh217

Cited by 282 publications

(323 citation statements)

References 20 publications

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“…VCs of iliac, femoral, radial, and digital arteries were assessed by x-ray of the pelvis and hands according to the AS (Supplemental Figure 1) (14). To analyze the prognostic effect of the location of VC, a separate analysis of VC of the radial and cubital arteries (AS-hands) was performed, because they are muscular arteries with a greater tendency to the calcification of the media (14).…”

Section: Vcsmentioning

confidence: 99%

“…To analyze the prognostic effect of the location of VC, a separate analysis of VC of the radial and cubital arteries (AS-hands) was performed, because they are muscular arteries with a greater tendency to the calcification of the media (14). Aortic calcifications were evaluated by lateral abdominal x-ray, which included from vertebra T-10 to the first two vertebrae of the sacrum according to the KS (Supplemental Figure 2) (17).…”

Section: Vcsmentioning

confidence: 99%

“…It has been postulated that the early diagnosis of VC and the treatment of the factors that promote it could reduce the high rate of cardiovascular mortality observed in patients with CKD (10)(11)(12)(13)(14). Although VC can be assessed by various methods, such as ultrasonography, tomography, and arteriography, simple radiology has the advantages of being simple, inexpensive, and commonly applicable in daily clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…Various studies have validated the use of the plain radiograph of the abdominal aorta (Kauppila score [KS]) or the hands and pelvis (simple VC score or Adragao score [AS]) as simpler and more affordable methods than tomography for showing the presence of VC, with a good correlation in patients on dialysis between coronary calcification (CC) and VC in other fields territories (14,17,18). In the dialysis population, the negative effect of VC on survival is well established in both the coronary territory and other locations (14,19,20).…”

Section: Introductionmentioning

confidence: 99%

“…In the dialysis population, the negative effect of VC on survival is well established in both the coronary territory and other locations (14,19,20). However, in patients with nondialysis CKD, only the long-term effect of CC is known (3).…”

Section: Introductionmentioning

confidence: 99%

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Vascular Calcification in Patients with Nondialysis CKD over 3 Years

Górriz¹,

Molina²,

Cerverón³

et al. 2015

Clinical Journal of the American Society of Nephrology

156

131

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Background and objectives Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed.Design, setting, participants, & measurements The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3-5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop .30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models.Results VC was present in 79% of patients and prominent in 47% (AS$3 or KS.6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P,0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P,0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS$3. After a median followup of 35 months (interquartile range=17-36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS$3 but not KS.6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event-free period (HR, 1.14; 95% CI, 1.06 to 1.22; P,0.001). VC did not predict renal progression.Conclusions VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful index to identify patients with CKD at high risk of death and morbidity as previously reported in patients on dialysis.

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Section: Vcsmentioning

confidence: 99%

Section: Vcsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Vascular Calcification in Patients with Nondialysis CKD over 3 Years

Górriz¹,

Molina²,

Cerverón³

et al. 2015

Clinical Journal of the American Society of Nephrology

156

131

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Evaluation of Renal Osteodystrophy and Serum Bone-Related Biomarkers in a Peritoneal Dialysis Population

Pereira

Magalhães

Mendonça

et al. 2020

Journal of Bone and Mineral Research

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The spectrum of renal osteodystrophy (ROD) in peritoneal dialysis (PD) patients remains to be clarified. Ideal intact parathormone (iPTH) levels range is still not defined. The role of sclerostin, dickkopf-related protein 1, osteoprotegerin, and receptor activator for nuclear factor κB ligand for the diagnosis of ROD needs to be elucidated. In this cross-sectional study, tetracycline double-labeled bone biopsy was performed in 49 patients with histomorphometric analysis according Kidney Disease Improving Global Outcomes (KDIGO) guidelines. All patients were treated with biocompatible PD solutions, with calcium concentration of 1.25 mmol/L. Adynamic bone was the most frequent diagnosed pattern (42.9%) followed by hyperparathyroid-related bone disease (28.6%). Twenty-two percent of patients had normal bone. In patients with iPTH within the KDIGO recommended range for dialysis patients, adynamic bone was found in 59% of cases. Median (range) iPTH in patients with adynamic bone was 312 (60-631) pg/mL. Median (range) levels of sclerostin varied from 1511.64 (458.84-6387.70) pg/mL in patients with hyperparathyroid bone disease to 2433.1 (1049.59-11354.52) pg/mL in patients with adynamic bone. Sclerostin/iPTH ratio was the best marker of low turnover disease but iPTH performed best in the diagnosis of high turnover disease. Calcium mass transfer was positive in patients with low bone volume. Adynamic bone is the most frequent ROD pattern in contemporary PD. Our results suggest the need to review the iPTH target range for this population. The sclerostin/iPTH ratio showed improved performance compared to iPTH for the diagnosis of low turnover bone.

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Extensive radiation‐induced atherosclerosis of the ascending aorta, pericardial and valvular calcifications in young adult survivor of childhood Hodgkin lymphoma

Cepelova

Kruseová

Dvořáková

et al. 2021

Pediatric Blood & Cancer

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A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients

Abstract: The present vascular calcification scoring represents a simple tool for the assessment of cardiovascular risk related with vascular calcifications in chronic HD patients.

Cited by 282 publications

References 20 publications

Vascular Calcification in Patients with Nondialysis CKD over 3 Years

Vascular Calcification in Patients with Nondialysis CKD over 3 Years

Evaluation of Renal Osteodystrophy and Serum Bone-Related Biomarkers in a Peritoneal Dialysis Population

Extensive radiation‐induced atherosclerosis of the ascending aorta, pericardial and valvular calcifications in young adult survivor of childhood Hodgkin lymphoma

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