The Association of Calcium-Phosphorus Product With the Severity of Cardiac Valves Failure in Patients Under Chronic Hemodialysis

Moshar, Simindokht; Bayesh, Seyedehsara; Mohsenikia, Maryam; Najibpour, Reza

doi:10.14740/cr465w

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…In humans, CKD is associated with cardiovascular disease, in particular atherosclerosis and vascular calcification, mineral and bone disorder, fractures and high risk of mortality (especially cardiovascular mortality) [ 23 , 25 , 26 , 27 ]. In human patients, high levels of sCaPP and high phosphate levels may lead to secondary hyperparathyroidism and are associated with calcification of softs tissues [ 28 ]. It is possible that in our cases, high levels of sCaPP may be associated with mineralization in other sites than kidneys (such as stomach, myocardium, lung and liver), as reported in patient with CKD [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases

Perondi

Lippi

Marchetti

et al. 2020

Veterinary Sciences

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In patients affected by chronic kidney disease (CKD), some ultrasonographic (US) abnormalities have been shown to correlate better than others with the progression of the disease. The aim of the study was to evaluate the prevalence of the most frequent renal US abnormalities in dogs at different stages of CKD, and to investigate their association with CKD International Renal Interest Society (IRIS) stages. Medical records and ultrasonographical report of 855 dogs were retrospectively included. The most frequent renal ultrasonographic abnormalities were: increased cortical echogenicity, abnormal ratio of cortico-medullary junction (C/M) and pyelectasia. A statistically significant difference in the prevalence of irregular contour, abnormal cortico-medullary junction, abnormal C/M, increased cortical echogenicity, and pyelectasia was found for dogs at different IRIS stages. The number of dogs with more than one US abnormality increased significantly with the progression of IRIS stage. In conclusion, increased cortical echogenicity, abnormal C/M junction and pyelectasia were the most prevalent US abnormalities in our CKD population. Although none of the US abnormalities showed a significantly higher prevalence, the number of dogs presenting > 3 US abnormalities increased significantly from IRIS 2 to IRIS 4. Renal US is an excellent ancillary diagnostic test, which should be used together with renal functional parameters, to monitor the progression of CKD.

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Section: Discussionmentioning

confidence: 99%

How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases

Perondi

Lippi

Marchetti

et al. 2020

Veterinary Sciences

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“…Some authors have contended that previous relevant guidelines can be set aside and that target phosphorus levels should be set to within the normal range [25]. Therefore, physicians have tried to reduce phosphate imbalance and maintain PTH levels within the target range, to reduce CKD-accelerated cardiovascular calcification [18,23,26].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of parathyroidectomy <i>versus</i> cinacalcet in the clinical management of secondary hyperparathyroidism

et al. 2019

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Parathyroidectomy (PTX) is the standard treatment for secondary hyperparathyroidism (SHPT); however, the administration of cinacalcet has gained prominence as a noninvasive treatment. We aimed to determine whether PTX or cinacalcet is more effective in preventing morbidity and mortality through reviewing follow-up data concerning surgical management of SHPT. We retrospectively analyzed and divided 209 patients with SHPT into two treatment groups: PTX (n = 78) and cinacalcet (n = 131) groups. We compared clinical features, the over-the-target range rate during pre-and postintervention periods, new cardiovascular events, and all-cause mortality between both groups. Almost all biochemical parameters were well controlled in the post-intervention period, and were within the recommended target range for the PTX group but not for the cinacalcet group. A significant difference was observed in the over-the-target range rate during the postintervention period between the groups. PTX and cinacalcet interventions significantly lowered the over-the-target range rates for serum intact parathyroid hormone (iPTH) (>300 pg/mL), corrected calcium (>10.5 mg/mL), serum phosphorus (>5.5 mg/ dL), and calcium-phosphorus product (>55) in both groups (p = 0.001). PTX reduced the risk of new cardiovascular events by 86% compared to cinacalcet (p = 0.001); however, all-cause mortality did not differ significantly (14.1% vs. 7.6%, p = 0.132). For patients with SHPT, PTX helps prevent cardiovascular events through normalizing biochemical variables, according to recommended guidelines. PTX should be considered before cinacalcet treatment to prevent new cardiovascular events. Early PTX for appropriate patients can help prevent immediate postoperative complications and mortality.

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Section: ．Discussionmentioning

confidence: 77%

“…Interestingly, our study also found that cardiac VC was a predictive factor in both the death and compound outcome models. The study found that the prevalence of aortic and mitral valve VC in MHD patients was eight times higher than that in the general population [26–28] . In patients receiving MHD, hyperphosphatemia, hyperparathyroidism, increased fibroblast growth factor-23, and decreased co-receptor klotho levels are significantly associated with VC [27] .…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a multivariate model for predicting heart failure hospitalization and mortality in patients receiving maintenance hemodialysis

tang

Yuan

Wang

et al. 2023

Preprint

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Background: Heart failure (HF) is a common cardiovascular disease in patients receiving maintenance hemodialysis (MHD). Once these patients on MHD exhibit HF, their hospitalization rate, mortality, and economic burden will be significantly increased. Early identification and prediction of hospitalization and death are of great importance for reducing hospitalization and mortality. This study used multicenter clinical data to develop and externally validate clinical risk models to predict expected mortality and HF hospitalization rates in MHD patients with HF. Materials and Methods: From January 2017 to October 2022, 348 patients receiving MHD from four participating centers were enrolled. Demographic data, MHD treatment modalities, laboratory tests, and echocardiography data were collected when the initial event occurred. Three centers were randomly assigned to the modeling dataset (n=258), and one center was assigned to the external validation set (n=90). Considering a composite outcome of HF hospitalization and death as the primary endpoint and hospitalization due to HF or death as the secondary endpoint, a COX clinical prediction model was constructed and verified using internal and external datasets. Results: The median age of patients in the modeling cohort was 63 years old, 41.5% of patients were women; 165 (61%) had a history of HF; 81 (31.4%) were hospitalized for HF; and 39 (15.1%) patients had died. The c-statistic values for composite outcome, hospitalization for HF, and mortality were 0.812, 0.808, and 0.811, respectively. The predictors of death and hospitalization outcomes caused by HF are significantly different. The strongest predictors of HF hospitalization outcomes were advanced age, multiple HF hospitalizations, hyponatremia, high levels of NT-proBNP and hs-cTnT, and larger MVe values. The strongest predictors of mortality were longer dialysis age, combined atrial fibrillation, calcification of the aortic or mitral valve (especially calcification, and in particular aortic valve calcification), pleural effusion, low serum sodium, and higher levels of hs-cTnT. The median age of the patients in the external validation cohort was 63 years old; 28.8% were female; 35 (38.1%) had a history of HF; 11 (12.2%) were hospitalized for HF; and 5 (5.6%) died. The c-statistic of the predictive models for composite outcome, hospitalisation for HF, and mortality was comparable to that of the modelling cohort. Conclusion: The model established in this study is stable and reliable and the included variables are easily obtained from the routine clinical environment. The model can provide useful risk factors and prognostic information for patients with MHD combined with HF.

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The Association of Calcium-Phosphorus Product With the Severity of Cardiac Valves Failure in Patients Under Chronic Hemodialysis

Cited by 12 publications

References 14 publications

How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases

How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases

Clinical outcomes of parathyroidectomy <i>versus</i> cinacalcet in the clinical management of secondary hyperparathyroidism

Development and validation of a multivariate model for predicting heart failure hospitalization and mortality in patients receiving maintenance hemodialysis

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