Fibrinogen and calcium x phosphate product are predictors of cardiovascular events in the CAPD population.
OBJECTIVE
Plasma fibrinogen (Fib) and calcium x phosphate product have emerged as cardiovascular (CV) event predictors in hemodialysis (HD) patients, but their role in peritoneal dialysis (PD) is less studied.


METHODS
We investigated whether Fib and calcium x phosphate product predict CV events in a prospective cohort study of 47 continuous ambulatory PD (CAPD) patients (mean follow-up 34.6 months).


RESULTS
During the follow-up, 29 patients experienced CV events, which were fatal in 11 of them. Plasma Fib was markedly elevated in the entire population studied (median 612 mg/dL inter-quartile range (IQ): 566-718 mg/dL). On univariate analysis, Fib was higher (p=0.02) in those patients who had fatal or non-fatal CV events (median 654 mg/dL, IQ: 577-801) than in event-free patients (median 579 mg/dL, IQ: 532-629). Patients with incident CV events also tended to have higher calcium x phosphate product (51.6 +/- 12.8 vs. 43.8 +/- 13.9 mg2/dL2, p=0.06). On multivariate Cox's regression analyses, including traditional risk factors and history of previous CV events, Fib (hazard ratio (HR) associated with 100 mg/dL increase in plasma Fib 1.29 95% confidence interval (CI) 1.03-1.63 (p=0.03)) and calcium x phosphate product (HR associated with a 5 mg2/dL2 increase 1.25 95% CI 1.05-1.49 (p=0.01)) emerged as independent CV event predictors.


CONCLUSIONS
Calcium x phosphate product and Fib are CV event predictors in CAPD patients.
Enia
Giuseppe
G
CNR-IBIM, Institute of Biomedicine, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension & Division of Nephrology, Reggio Calabria - Italy. eniag@libero.it
Panuccio
Vincenzo
V
Mallamaci
Francesca
F
Tripepi
Giovanni
G
Mandalari
Antonella
A
Zoccali
Carmine
C
D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002130:Calcium Phosphates / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010710:Phosphates / Q000097:blood; D011379:Prognosis; D011863:Radioimmunoassay; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D015415:Biomarkers; D002130:Calcium Phosphates; D010710:Phosphates; D005340:Fibrinogen; D002097:C-Reactive Protein; C020243:calcium phosphate; D002118:Calcium