Prevalence and progression of cardiovascular calcifications in peritoneal dialysis patients: A prospective study.
BACKGROUND
Patients on dialysis may have abnormal serum levels of Ca, P and parathyroid hormone, with related bone diseases. This population has an increased risk of death, with cardiovascular calcification (CC) a contributing factor. Patients on peritoneal dialysis appear to be at increased risk of hyperlipidemia, a contributing factor to atherosclerotic plaque formation. Although several studies have described the presence and progression of CC in hemodialysis populations, there are fewer data in patients on peritoneal dialysis.


METHODS
The Renal Osteodystrophy and Calcifications: Key factors in Peritoneal Dialysis (ROCK-PD) study was a 36-month, prospective observational study conducted in Italy. The study examined the presence and progression of CC in two cardiac valves and five arterial sites. The potential associations of serum Ca and P with mortality and cardiovascular morbidity, demographic, clinical and blood chemistry variables was investigated.


RESULTS
CC was present in 77% of patients at baseline (N=369) and in 90% of patients by study end (N=145), progressing in 73% of patients. There were 42 deaths (11%). Analyses showed a marked correlation between baseline P levels and the presence of left ventricular hypertrophy. However, there were no consistent correlations between serum Ca or P with mortality or morbidity.


CONCLUSIONS
CC was common in peritoneal dialysis patients and progressed in a majority of patients.
Nephrology and Dialysis Unit-Ospedale San Carlo Borromeo, Milan, Italy.
Maurizio
M
Gallieni
Flavia
F
Caputo
Armando
A
Filippini
Paolo
P
Gabella
Michele
M
Giannattasio
Antonio
A
Stingone
Marco
M
Farina
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D002118:Calcium / Q000097:blood; D009202:Cardiomyopathies / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D003710:Demography; D018450:Disease Progression; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000150:complications; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D016019:Survival Analysis; D055815:Young Adult
D010758:Phosphorus; D002118:Calcium