Lateral lumbar X‐ray assessment of abdominal aortic calcification in Australian haemodialysis patients

Toussaint, Nigel D; Pedagogos, Eugenie; Lau, Ken; Heinze, Stefan; Becker, Gavin J.; Beavis, Jennifer; Polkinghorne, Kevan R.; Damasiewicz, Matthew J; Kerr, Peter G.

doi:10.1111/j.1440-1797.2010.01420.x

Cited by 32 publications

(42 citation statements)

References 44 publications

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“…Factors such as presence of diabetes, hypertension, prior history of cardiovascular disease, and longer dialysis vintage were also significantly associated with higher AAC score. These findings were similar to prior crosssectional study results, 5,14 which showed that the most contributive factors for vascular calcification were patient's age, dialysis vintage and prior history of CAD.…”

Section: Discussionsupporting

confidence: 91%

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

2019

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Aim Abdominal aortic calcification (AAC) score in dialysis patients was associated with coronary artery disease (CAD) in cross‐sectional study, but the use of AAC score in the CAD prediction was not clear. We aimed to use AAC score in the estimation of CAD occurrence in middle‐aged peritoneal dialysis (PD) patients. Methods Middle‐aged (45–65 years old) PD patients were recruited and followed up until CAD occurrence, patient mortality, or PD failure. We quantified AAC score by lateral lumbar radiography, and used receiver operation curve (ROC) analysis to find the cut‐off value for CAD prediction. Results There were 187 patients recruited for study with a mean follow‐up of 1027 ± 427 days. AAC score in patients with CAD during follow‐up period (9.7 ± 7.6, n = 41) was higher than in patients without CAD occurrence (5.5 ± 6.1, n = 146) (P < 0.001). Multivariate hazard ratio of AAC score for CAD was 1.07 (P = 0.044). ROC showed that AAC score of 5.5 had a sensitivity of 0.667 and a specificity of 0.581 in the prediction of CAD occurrence. Patients with AAC score above 5.5 had significantly higher cumulative incidence of CAD than patients with AAC score below 5.5 (Log‐rank test, P = 0.003). Age (P = 0.002), diabetes (P = 0.002), hypertension (P = 0.032), longer dialysis vintage (P < 0.001) and lower serum potassium (P = 0.012) were parameters significantly associated with higher AAC score. Conclusion AAC score can predict CAD occurrence in PD patients. Age, diabetes, hypertension, dialysis vintage and serum potassium level are factors associated with higher AAC score.

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Section: Discussionsupporting

confidence: 91%

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

2019

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“…Abdominal aortic calcification (AAC) was assessed using a previously validated 24-point scale [17]. All subjects were assessed independently by two investigators blinded to patient demographics and serum markers.…”

Section: Methodsmentioning

confidence: 99%

Relationship of Serum Soluble Klotho Levels and Echocardiographic Parameters in Patients on Maintenance Hemodialysis

Zhang

Guo

et al. 2019

Kidney Blood Press Res

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Background: Cardiovascular disease is the leading cause of morbidity and mortality in maintenance hemodialysis (MHD) patients. Uremic cardiomyopathy, characterized by myocardial hypertrophy and fibrosis, has a significant contribution to these adverse cardiac outcomes. The protective effect of soluble Klotho (s-Klotho) on myocardial damage was demonstrated in in vitro and animal experiments. However, data from MHD patients is limited. The present study was designed to identify potential correlations between echocardiographic parameters and serum s-Klotho levels in MHD patients. Methods: This is a cross-sectional study involving 105 MHD patients from the Dialysis Center of Capital Medical University affiliated Beijing Friendship Hospital between March and October 2014. The general information for each patient was recorded. Fasting blood samples were collected prior to hemodialysis during the mid-week session in all patients. The echocardiogram and left lateral lumbar spine radiograph were performed after the same mid-week session. The dialysis records for each session within 3 months before the blood tests were documented. According to the quartiles of s-Klotho levels, patients were divided into four groups (Group 1–4). The demographic and clinical characteristics, echocardiographic parameters, and abdominal aortic calcification scores among the groups were compared. Results: The enrolled 105 patients were predominantly male (54.3%) with an average age of 59.9 ± 11.2 years. Previous hemodialysis durations were 76 (42–133) months. Sixteen (15.2%) patients had diabetes mellitus. Mean serum s-Klotho level was 411.83 ± 152.95 pg/mL, and the 25th percentile, 50th percentile, and 75th percentile values of serum s-Klotho levels were 298.9, 412, and 498.2 pg/mL, respectively. Individuals in the bottom quartile of s-Klotho levels (Group 1) had significantly increased interventricular septal thickness (IVST) compared to those in the other three quartiles of s-Klotho levels (Group 1: 1.12 ± 0.16 cm; vs. Group 2: 1.12 ± 0.16 cm, p = 0.008; vs. Group 3: 0.94 ± 0.13 cm, p < 0.001; vs. Group 4: 1.03 ± 0.1 5 cm, p = 0.022). There were significant differences in the ratios of IVST and posterior wall thickness (PWT) between patients of Group 1 and Group 3 (1.12 ± 0.1 2 vs. 1.00 ± 0.1 4, p = 0.004). No significant differences were found for other parameters among the groups. The univariate correlation analyses showed that gender (r = –0.211, p = 0.030), Kt/V urea (r = –0.240, p = 0.014), hypersensitive C reactive protein (hs-CRP) (r = 0.196, p = 0.045), and serum s-Klotho levels (r = –0.260, p = 0.007) significantly correlated with IVST. Ultimately, only hs-CRP and serum s-Klotho levels were entered into a multiple regression model. Conclusions: The present study showed that patients with lower circulating s-Klotho levels were more often associated with larger IVST and greater ratios of IVST and PWT. There was an independent association between s-Klotho and IVST, and lower s-Klotho levels seem to be a potential risk factor of uremic...

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“…Associations between age, DM and CVD with the severity of VC in different CKD populations have been described previously . In CKD stage 5D patients, the relationship between dialysis vintage and the severity of VC has been documented . In KT recipients, dialysis vintage has been shown to predict the progression of VC in the early post‐transplantation period .…”

Section: Discussionmentioning

confidence: 71%

“…4,[19][20][21] In CKD stage 5D patients, the relationship between dialysis vintage and the severity of VC has been documented. 4,15,19,21 In KT recipients, dialysis vintage has been shown to predict the progression of VC in the early post-transplantation period. 22 There has been no report on the relationship between dialysis vintage and the severity of VC in long-term-KT recipients until the present study.…”

Section: Discussionmentioning

confidence: 99%

“…12 This method has been validated in dialysis patients which demonstrated a high correlation with coronary artery calcification (CAC) scores obtained by computed tomography (CT) and the presence of CVD. 14,15 Lateral lumbar spine radiograph is recommended by KDIGO (Kidney Disease Improving Global Outcome) as an alternative to CT for the detection of VC. 16 Iliac and femoral arterial calcifications were examined using a pelvic radiograph and scored according to Adragao et al method (Total score 0-4).…”

Section: Vascular Calcificationmentioning

confidence: 99%

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Vascular calcification in long‐term kidney transplantation

et al. 2014

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Lateral lumbar X‐ray assessment of abdominal aortic calcification in Australian haemodialysis patients

Cited by 32 publications

References 44 publications

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

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

Relationship of Serum Soluble Klotho Levels and Echocardiographic Parameters in Patients on Maintenance Hemodialysis

Vascular calcification in long‐term kidney transplantation

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