title: Comparing different calcification scores to detect outcomes in chronic kidney disease patients with vascular calcification.
abstract: BACKGROUND
  There is no consensus on the most appropriate technique to diagnose vascular calcification in chronic kidney disease. This is primarily because of the absence of direct comparisons of predictive values of the various calcification scores, especially outside the coronary vascular beds, to detect clinical outcomes.
  
  
  METHODS
  We included 93 haemodialysis patients and performed 6 vascular calcification scores: two scores utilised simple X-rays of abdominal aorta and peripheral vessels. CT scans of the thoracic, upper abdominal and lower abdominal aorta were performed to calculate the aortic calcification index and CT of the pelvis for calcification of iliac vessels. Patients were followed for 63months (mean 46.8months) for first major cardiovascular events and mortality.
  
  
  RESULTS
  Nineteen cardiovascular events and 28 deaths occurred. Calcification was detected more sensitively in central and peripheral beds using CT scans compared to X-rays (p<0.001). CT scans detected calcification more frequently in distal than proximal vascular beds (p<0.001). Calcification of the pelvic vessels and lower abdominal aorta were most predictive of events including pre-existing cardiovascular disease O.R. 6.5 (95% C.I. 2-22; p=0.001) and O.R. 3 (95% C.I. 1.1-9; p=0.035); new major cardiovascular events H.R. 4.2 (95% C.I. 1.5-11; p=0.006) and H.R. 2 (95% C.I. 0.8-5.3; p=0.1) as well as mortality H.R. 2.8 (95% C.I. 1.3-6; p=0.01) and H.R. 2.2 (95% C.I. 1.04-5; p=0.04) respectively.
  
  
  CONCLUSIONS
  CT based techniques are more sensitive than plain X-rays at detecting peripheral and aortic vascular calcifications. Distal CT scans of the aorta and pelvic vessels have the highest predictive value for cardiovascular events and mortality.
authors.affiliation: Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt. Electronic address: mmnasrallah@kasralainy.edu.eg.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: NasrAllah
authors.affiliation: Kasr AlAiny School of Medicine, Cairo University, Radiology, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Nassef
authors.affiliation: Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt.
authors.forename: Tarik H
authors.initials: TH
authors.lastname: Elshaboni
authors.affiliation: Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt.
authors.forename: Fadia
authors.initials: F
authors.lastname: Morise
authors.affiliation: Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt.
authors.forename: Noha A
authors.initials: NA
authors.lastname: Osman
authors.affiliation: Kasr AlAiny School of Medicine, Cairo University, Nephrology, Saray Street, Manial, Cairo, Egypt.
authors.forename: Usama A
authors.initials: UA
authors.lastname: Sharaf El Din
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging* / Q000401:mortality; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000401:mortality
keywords: Aortic calcification; Kidney disease; Vascular calcification