Assessment of abdominal aortic calcification in predialysis chronic kidney disease and maintenance hemodialysis patients

Jagadeswaran, Dhakshinamoorthy; Elumalai, Ramprasad; Dev, Bhawana; Hemamalini, A. J.; Sai, PM Venkata; Periasamy, Sivakumar

doi:10.4103/1319-2442.220855

Cited by 5 publications

(3 citation statements)

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“…Vascular calcification, an advanced atherosclerotic pathological process similar to osteogenesis that is involved in the intima or media of blood vessels 1 , is associated with elevated cardiovascular morbidity and mortality in patients with diabetes mellitus (DM) or end-stage renal disease 2 , 3 . Vascular calcification is an active, complex, and chronic process involving inflammation, oxidative stress, and apoptosis 4 – 6 .…”

Section: Introductionmentioning

confidence: 99%

Advanced glycation end products accelerate calcification in VSMCs through HIF-1α/PDK4 activation and suppress glucose metabolism

Zhu

Han

et al. 2018

Sci Rep

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Arterial media calcification is associated with diabetes mellitus. Previous studies have shown that advanced glycation end products (AGEs) are responsible for vascular smooth muscle cell (VSMC) calcification, but the underlying mechanisms remain unclear. Hypoxia-inducible factor-1α (HIF-1α), one of the major factors during hypoxia, and pyruvate dehydrogenase kinase 4 (PDK4), an important mitochondrial matrix enzyme in cellular metabolism shift, have been reported in VSMC calcification. The potential link among HIF-1α, PDK4, and AGEs-induced vascular calcification was investigated in this study. We observed that AGEs elevated HIF-1α and PDK4 expression levels in a dose-dependent manner and that maximal stimulation was attained at 24 h. Two important HIF-1α-regulated genes, vascular endothelial growth factor A (VEGFA) and glucose transporter 1 (GLUT-1), were significantly increased after AGEs exposure. Stabilization or nuclear translocation of HIF-1α increased PDK4 expression. PDK4 inhibition attenuated AGEs-induced VSMC calcification, which was evaluated by measuring the calcium content, alkaline phosphatase (ALP) activity and runt-related transcription factor 2 (RUNX2) expression levels and by Alizarin red S staining. In addition, the glucose consumption, lactate production, key enzymes of glucose metabolism and oxygen consumption rate (OCR) were decreased during AGEs-induced VSMC calcification. In conclusion, this study suggests that AGEs accelerate vascular calcification partly through the HIF-1α/PDK4 pathway and suppress glucose metabolism.

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Section: Introductionmentioning

confidence: 99%

Advanced glycation end products accelerate calcification in VSMCs through HIF-1α/PDK4 activation and suppress glucose metabolism

Zhu

Han

et al. 2018

Sci Rep

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“…This result matches those already published, suggesting that CRP levels positively correlate with coronary artery calcifications in patients with both early and advanced stages of CKD and that in patients on hemodialysis, CRP is associated with valvular calcifications, with aortic valve calcifications leading to aortic stenosis, with arterial calcification score, and in general with cardiovascular (both valvular and vascular) calcifications [22,27,[31][32][33]. Moreover, CRP has been shown to be an independent predictor of abdominal aortic calcification in patients on both peritoneal dialysis and hemodialysis [34][35][36].…”

Section: Discussionmentioning

confidence: 97%

Cardiovascular Calcifications Are Correlated with Inflammation in Hemodialysis Patients

Dragoș,

Timofte,

Georgescu

et al. 2023

Medicina

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Background and Objectives: The main cause of morbidity and mortality in hemodialysis patients is cardiovascular disease, which is quite common. The main objective of our study was to investigate the relationship between oxidative stress, inflammation, and vascular and valvular calcifications in hemodialysis patients. Materials and Methods: This observational study had 54 hemodialysis patients, with an average age of 60.46 ± 13.18 years. Cardiovascular ultrasound was used to detect and/or measure aortic and mitral valve calcifications, carotid and femoral atheroma plaques, and common carotid intima-media thickness. The aortic calcification score was determined using a lateral abdomen plain radiograph. The inflammatory, oxidative, metabolic, and dietary statuses, as well as demographic characteristics, were identified. Results: There were significant correlations between the levels of IL-6 and carotid plaque number (p = 0.003), fibrinogen level and aortic valve calcifications (p = 0.05), intima-media thickness (p = 0.0007), carotid plaque number (p = 0.035), femoral plaque number (p = 0.00014), and aortic calcifications score (p = 0.0079). Aortic annulus calcifications (p = 0.03) and intima-media thickness (p = 0.038) were adversely linked with TNF-α. Nutrition parameters were negatively correlated with atherosclerosis markers: number of carotid plaques with albumin (p = 0.013), body mass index (p = 0.039), and triglycerides (p = 0.021); number of femoral plaques with phosphorus (0.013), aortic calcifications score with albumin (p = 0.051), intima-media thickness with LDL-cholesterol (p = 0.042). Age and the quantity of carotid plaques, femoral plaques, and aortic calcifications were linked with each other (p = 0.0022, 0.00011, and 0.036, respectively). Aortic annulus calcifications (p = 0.011), aortic valve calcifications (p = 0.023), and mitral valve calcifications (p = 0.018) were all associated with an increased risk of death. Conclusions: Imaging measures of atherosclerosis are adversely connected with dietary status and positively correlated with markers of inflammation and risk of mortality.

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“…Hasil ini juga sama dengan penelitian Dhakshinamoorthy, dkk. 22 yang mendapatkan usia (p=0,023, OR:1,09) dan lama HD (p=0,005, OR:1,17) menjadi faktor risiko terjadinya kalsifikasi aorta abdomen (AAC) pada pasien PGK yang menjalani HD. Peeters, dkk.…”

Section: Diskusiunclassified

Hubungan antara Kadar Serum PTH dengan Kalsifikasi Aorta Abdominal pada Pasien Hemodialisis Kronik di RSUP Dr. Mohammad Hoesin Palembang

Akbar¹,

Ali

Indrajaya

et al. 2021

JPDI

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Pendahuluan. Penyakit kardiovaskular adalah penyebab kematian yang paling sering pada pasien penyakit ginjal kronik (PGK). Hal ini dibuktikan dengan ditemukannya kalsifikasi vaskular pada pasien PGK. Proses kalsifikasi vaskular yang terjadi sering dikaitkan dengan kondisi hiperparatiroid sekunder yang merupakan komplikasi dari pasien PGK. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar parathyroid hormone (PTH) serum dengan kalsifikasi aorta abdominal pada pasien PGK yang menjalani hemodialisis (HD).Metode. Penelitian observasional analitik uji korelasi dengan desain cross sectional yang dilakukan di ruang perawatan penyakit dalam RSUP dr. Mohammad Hoesin Palembang dari Juli hingga Desember 2019. Populasi penelitian adalah semua pasien PGK yang telah menjalani HD >3 bulan dengan usia >18 tahun. Semua pasien dilakukan pemeriksaan kadar serum PTH dan dilakukan pengukuran derajat kalsifikasi aorta abdomen menggunakan lateral lumbal X-ray yang dihitung menggunakan skor Kauppila.Hasil. Dari 86 pasien HD yang diteliti, terdapat 65 pasien (75,6%) yang mempunyai kadar serum PTH yang tinggi dan 46 pasien (53,5%) yang mempunyai kalsifikasi pada aorta abdomen. Uji korelasi Spearman mendapatkan kadar serum PTH mempunyai hubungan dengan skor Kauppila (p=0,014, r=0,264). Analisis multivariat regresi linear mendapatkan usia (p<0,001, r=0,510), lama HD (p=0,020, r=0,256), riwayat hipertensi (p=0,031, r=0,239) dan kadar fosfat serum (p=0,011 r=0,281) mempunyai hubungan terhadap skor Kauppila.Simpulan. Terdapat hubungan yang signifikan antara kadar serum PTH dengan kalsifikasi aorta abdomen pada pasien HD kronik. Faktor usia, lama HD, hipertensi, dan kadar fosfat serum juga berpengaruh terhadap kejadian kalsifikasi aorta abdomen.

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Assessment of abdominal aortic calcification in predialysis chronic kidney disease and maintenance hemodialysis patients

Cited by 5 publications

References 0 publications

Advanced glycation end products accelerate calcification in VSMCs through HIF-1α/PDK4 activation and suppress glucose metabolism

Advanced glycation end products accelerate calcification in VSMCs through HIF-1α/PDK4 activation and suppress glucose metabolism

Cardiovascular Calcifications Are Correlated with Inflammation in Hemodialysis Patients

Hubungan antara Kadar Serum PTH dengan Kalsifikasi Aorta Abdominal pada Pasien Hemodialisis Kronik di RSUP Dr. Mohammad Hoesin Palembang

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