Abdominal Aortic Calcification is an Independent Predictor of Cardiovascular Events in Peritoneal Dialysis Patients

Abstract

Abdominal aortic calcification (AAC) is reported as a predictor for cardiovascular events in general population and in hemodialysis patients. At present, there are no AAC data in peritoneal dialysis. The purpose of this study was to evaluate the prognostic role of AAC score on cardiovascular events in peritoneal dialysis patients. Seventy‐four peritoneal dialysis patients were enrolled. AAC was measured on baseline lateral abdomen radiographs by the semi‐quantitative method as described by Kauppila. The other cardiovascular risk factors were obtained from patient history and blood examination. The Kaplan–Meier method was used to evaluate freedom from cardiovascular events, and differences were assessed with the log‐rank statistic. Multivariate Cox regression models addressed time to cardiovascular events. The median period of follow‐up was 30.5 months (IQR 19.4–32.7). During follow‐up, there were 29 cardiovascular events (39.2%). In univariable analysis, patient's age (HR = 1.050; P = 0.001), urine output (HR = 0.999; P = 0.02), and AAC stratified by tertiles (overall P‐value < 0.001) were significantly associated with cardiovascular events. In multivariable regression analysis, AAC score stratified by tertiles was the only independent predictor for cardiovascular events (overall P‐value <0.001). To our knowledge, we have shown for the first time that AAC score is an independent predictor of cardiovascular events in peritoneal dialysis patients. Risk stratification by assessment of AAC score may provide important information for the management of cardiovascular disease in peritoneal dialysis patients without any additional expense, because these patients have several abdominal X‐ray scans to evaluate the catheter position.

Prevalence of abdominal aortic calcifications in older living renal donors and its effect on graft function and histology

“…AAC is a common finding on imaging studies, especially with advancing age, and it is associated with cardiovascular and renal diseases [9][10][11]. Due to the increasing number of older kidney donors, incidental AAC is noted with increasing frequency in otherwise healthy donors during their predonation imaging workup.…”

Abdominal aortic calcification score predicts the occurrence of coronary artery disease in middle‐aged peritoneal dialysis patients

“…There was only one study previously that used AAC score in prediction of cardiovascular events in PD patients . Francesca Martino et al reported AAC that can be an independent predictor for cardiovascular events in a study of 74 PD patients.…”

“…In their study, cardiovascular events were defined as non‐fatal myocardial infarction, prolonged angina pectoris, limb ischaemia, transient ischaemia attack, and cardiovascular death. In our study, we aimed to know the association between AAC and CAD . We defined CAD events as myocardial ischaemia symptoms with positive finding in coronary angiography study.…”

Aortic Arch Calcification and Bone-Associated Molecules in Peritoneal Dialysis Patients

“…Arterial media calcification has previously been shown to be an independent risk factor for mortality in HD patients [14]. Martino et al [15] showed for the first time the predictive value of abdominal AoACs for outcomes in Italian PD patients. In a recent report from Korea [16], 184 dialysis patients (32% PD) were enrolled.…”