C-reactive protein is a significant predictor of vascular calcification of both aorta and hand arteries

Ishimura, Eiji; Okuno, Senji; Kitatani, T; Maekawa, Tomoki; Izumotani, Tsuyoshi; Yamakawa, Tomoyuki; Jono, Shuichi; Shoji, Tetsuo; Shioi, Atsushi; Inaba, Masaaki; Massry, Shaul G.; Nishizawà, Yoshiki

doi:10.1016/j.semnephrol.2004.06.008

Cited by 37 publications

(32 citation statements)

References 31 publications

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“…Low serum albumin as well as high CRP was described to be associated with peripheral arterial occlusive disease. [19,20] Therefore, in our pilot study, we concurrently examined the relationship of basic biochemical parameter of malnutrition, inflammation, lipid metabolism, and calcification to peripheral microcirculation. According to our results, in addition to ultrafiltration, these metabolic changes may also play a role in skin microcirculation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Skin Microcirculation during Hemodialysis

et al. 2010

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Background. Cardiovascular mortality in hemodialysis (HD) patients remains high despite improvements in HD technique such as dialysis adequacy, dialysis fluid purity, and membrane biocompatibility. Optimal fluid balance to maintain optimal hemodynamic stability during hemodialysis (HD) procedure is essential. At the present time, hemodynamic stability is conventionally assessed as stability of macrocirculation, especially as maintenance of systemic blood pressure with no attention paid to peripheral perfusion. Peripheral ischemic vascular disease represents a serious problem with high mortality and morbidity. We estimated skin microcirculation changes during HD using new device, Laser Doppler Line Scanner (Moor Instruments, Devon, UK). Aims. The aims were to introduce the novel method of detection of skin perfusion changes during hemodialysis and to evaluate possible relationship of these to ultrafiltration as well as to selected biochemical characteristics. Methods. In 36 hemodynamically stable patients, we performed paired measurements of skin blood flow in both hands before and during HD with registering the time of dialysis and the total ultrafiltration achieved. Results. We found a significant decrease in a majority of the evaluated areas. However, the skin blood flow change was not homogenous as it decreased more on the fingers. Conclusion.To our knowledge, this is the first study when the microcirculatory changes during hemodialysis are demonstrated and evaluated in large skin surface area, and showing not only a decrease in a majority of areas but also the heterogeneity of the changes.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Skin Microcirculation during Hemodialysis

et al. 2010

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“…Radiographic surveys were previously used to evaluate vascular calcification in HD patients [15][16][17][18]. For the purpose of this study, vascular calcification was defined by the presence of visible arterial calcification of the hand arteries on plain roentgenographs.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is easily performed in clinical practice without the need for special equipment such as electron beam computed tomography. Using this method had revealed statistically significant associations between vascular calcification and different clinical parameters [15][16][17][18]. Some investigators examining factors affecting vascular calcification in HD patients have emphasized the importance of calcium-phosphate metabolism while neglecting the role of magnesium [18,19].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Peripheral Vascular Calcification and Serum Magnesium Level in a Group of Egyptian Hemodialysis Patients

Okasha¹,

Bendary²,

Mourad³

2010

Arab J. Nephr. Trans

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Introduction: Vascular calcification is a risk factor for cardiovascular mortality in the general population. It is highly prevalent in end stage renal disease (ESRD) patients. Low magnesium (Mg) levels have been reported to have a strong association with vascular calcification in hemodialysis (HD) patients. The aims of this study were to evaluate the prevalence of vascular calcification and its relation to serum Mg concentration in a group of Egyptian HD patients. Methods:We studied 65 stable patients undergoing maintenance HD for more than 6 months. Vascular calcification was evaluated using hand roentgenography. Serum Mg, phosphorus, corrected calcium and intact parathyroid hormone (iPTH) levels were compared between patients with and without vascular calcification. Results:The study included 41 male and 24 female patients, aged 43-70 years. Vascular calcification was present in 38.5% of the patients. Mean serum Mg level was 2.88 ± 0.51 mg/dl. Male gender was more common in patients with vascular calcification, and they had significantly longer HD duration and significantly higher serum phosphorus and iPTH levels. Serum Mg level was significantly lower in patients with vascular calcification (2.36 ± 0.26 mg/dl vs.3.21 ± 0.32 mg/dl, p = 0.001). Serum Mg concentration remained as independent negative predictor of hand-artery vascular calcification after adjustment for age, gender, duration of HD, serum phosphorus and iPTH levels. Conclusion:Vascular calcification is common in the study population and is associated with a lower serum Mg level. High or sustained-normal Mg levels may have a protective role against the development of vascular calcification in HD patients.

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“…In coronary arteries of patients with CKD, in situ expression of markers of inflammation were found to be elevated and correlated to increased vascular calcification (17). In hemodialysis patients, CRP is a significant predictor of both intimal and medial calcification in the aorta and in peripheral arteries (35). Against this background, also genetic factors have to be taken into consideration because polymorphisms of the inflammatory adhesion molecule E-selectin have been associated with coronary calcification in young women (36).…”

Section: Which Common Pathomechanisms Are Shared By Intimal and Mediamentioning

confidence: 99%

Media Calcification and Intima Calcification Are Distinct Entities in Chronic Kidney Disease

Amann¹

2008

Clinical Journal of the American Society of Nephrology

336

243

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Calcification of the vascular tree is common in physiologic and pathologic conditions, i.e., aging, diabetes, dyslipidemia, genetic diseases, and diseases with disturbances of calcium metabolism. In chronic kidney disease, vascular calcification is even more common, develops early, and contributes to the markedly increased cardiovascular risk in this particular population. Pathomorphologically, atherosclerosis (i.e., plaque-forming degenerative changes of the aorta and of large elastic arteries) and arteriosclerosis (i.e., concentric media thickening of muscular arteries) can be distinguished. Increasing knowledge about calcification together with improved imaging techniques provided evidence that also vascular calcification has to be divided into two distinct entities according to the specific sites of calcification within the vascular wall: Patchy calcification of the intima in the vicinity of lipid or cholesterol deposits as present in plaque calcification and calcification of the media in the absence of such lipid or cholesterol deposits, known as Mö nckeberg-type atherosclerosis. The two types of calcification may vary according to the type of vessel (large elastic versus smaller muscular type artery) and proximal versus distal sites of the arterial tree. Furthermore, clinical studies showed that it is not purely academic to distinguish between intimal and medial calcification but rather relevant for the clinical presentation, treatment, and prognosis because each type leads to different clinical consequences. In vivo studies in animal models provided evidence in favor of common pathomechanisms between vascular calcification and atherosclerosis; however, there is other, strong experimental and clinical evidence that pleads for the continued distinction between intimal and medial calcification.

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C-reactive protein is a significant predictor of vascular calcification of both aorta and hand arteries

Cited by 37 publications

References 31 publications

Evaluation of Skin Microcirculation during Hemodialysis

Evaluation of Skin Microcirculation during Hemodialysis

Evaluation of Peripheral Vascular Calcification and Serum Magnesium Level in a Group of Egyptian Hemodialysis Patients

Media Calcification and Intima Calcification Are Distinct Entities in Chronic Kidney Disease

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