title: Total and individual coronary artery calcium scores as independent predictors of mortality in hemodialysis patients.
abstract: Many traditional and nontraditional risk factors contribute to vascular calcification among maintenance hemodialysis (MHD) patients. It is not clear whether coronary artery calcification (CAC) delineates a higher mortality risk independent of known risk factors. We examined 6-year (10/2001-9/2007) survival of 166 MHD patients, aged 53 +/- 13 years, with baseline CAC scores. Patients were grouped into four CAC groups: 0, 1-100, 101-400, and 400+. The 101-400 and 400+ groups were associated with a significantly higher adjusted risk of death than CAC 0 with hazard ratios (HR) 8.5 (95% CI: 1.1-48.1, p = 0.02) and 13.3 (95% CI: 1.3-65.1, p = 0.01), respectively, independent of demographics, comorbidity, lipids and other cardiovascular risks, surrogates of bone disease, nutritional and inflammatory markers and dialysis dose. Total CAC [HR 6.7 (1.1-21.5, p = 0.03)] followed by the presence of CAC in the left main [4.6 (2.2-9.8, p = 0.001)] and left anterior descending artery [4.3 (2.1-14.2, p = 0.001)] were strong independent predictors of mortality even after adjusting for above covariates. Total and vessel-specific CAC predict mortality in MHD patients independent of traditional and nontraditional risk factors.
authors.affiliation: Harold Simmons Center for Kidney Disease Research and Epidemiology, Torrance, Calif., USA.
authors.forename: Ronney S
authors.initials: RS
authors.lastname: Shantouf
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Naser
authors.initials: N
authors.lastname: Ahmadi
authors.forename: Arshia
authors.initials: A
authors.lastname: Ghaffari
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Flores
authors.forename: Ambarish
authors.initials: A
authors.lastname: Gopal
authors.forename: Nazanin
authors.initials: N
authors.lastname: Noori
authors.forename: Jennie
authors.initials: J
authors.lastname: Jing
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kovesdy
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
mesh_terms: D000328:Adult; D002118:Calcium / Q000378:metabolism*; D002614:Chelating Agents / Q000494:pharmacology; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000737:chemistry; D011073:Polyamines / Q000737:chemistry; D006435:Renal Dialysis / Q000009:adverse effects*; D000069603:Sevelamer; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002614:Chelating Agents; D011073:Polyamines; D010758:Phosphorus; D000069603:Sevelamer; D002118:Calcium
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