Total and individual coronary artery calcium scores as independent predictors of mortality in hemodialysis patients.
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.
Shantouf
Ronney S
RS
Harold Simmons Center for Kidney Disease Research and Epidemiology, Torrance, Calif., USA.
Budoff
Matthew J
MJ
Ahmadi
Naser
N
Ghaffari
Arshia
A
Flores
Ferdinand
F
Gopal
Ambarish
A
Noori
Nazanin
N
Jing
Jennie
J
Kovesdy
Csaba P
CP
Kalantar-Zadeh
Kamyar
K
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
D002614:Chelating Agents; D011073:Polyamines; D010758:Phosphorus; D000069603:Sevelamer; D002118:Calcium
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