title: Coronary risk score for mineral bone disease in chronic non-diabetic hemodialysis patients: results from a prospective pilot study.
abstract: BACKGROUND
  Chronic kidney disease-mineral bone disorder enhances coronary artery impairment (often occult and difficult to diagnose) in hemodialysis (HD) patients. The aim of the study was to correlate biochemical and imagistic parameters of MBD with the degree of documented coronary artery disease (CAD) in non-diabetic HD patients, in order to obtain a MBD-coronary risk score as a screening algorithm.
  
  
  METHODS
  A 3-year prospective study was conducted on 168 non-diabetic HD patients, evaluating MBD biochemical parameters along with pulse wave velocity (PWV) determination and valve/coronary calcification assessment; coronary angiography was performed in symptomatic patients. Correlations between noninvasive parameters and the degree of coronary obstruction were assessed using IBM SPSS Statistics 20 software, Chi-square test and the determination of odds ratio.
  
  
  RESULTS
  Significant differences in serum calcium (p < 0.001), phosphates (p = 0.03), bicarbonate (p < 0.001), albumin and iPTH (p = 0.002), percentage of deviations from PWV normal values (p = 0.004), average doses of phosphate binders and vitamin D and the number of vascular/valve calcifications were noted between the study group (angina, n = 17) and control group (asymptomatic, n = 151). After applying MBD-coronary risk score in control group, coronary angiography was performed in high-score patients.
  
  
  CONCLUSIONS
  A noninvasive screening algorithm for early diagnosis of CAD in asymptomatic HD patients with altered MBD parameters is necessary. Applying MBD-coronary risk score might be an important step in the prevention of major coronary episodes by extending the indication for further investigations, early diagnosis and treatment management.
authors.affiliation: Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital Bucharest, 37th Dionisie Lupu StreetSector 2, 020021, Bucharest, Romania.|Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Cristiana
authors.initials: C
authors.lastname: David
authors.affiliation: Department of Nephrology, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Bover
authors.affiliation: Department of Internal Medicine, "St. John" Emergency Clinical Hospital Bucharest, Bucharest, Romania.|Clinical Department No. 1, "Carol Davila" University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Voiculet
authors.affiliation: Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital Bucharest, 37th Dionisie Lupu StreetSector 2, 020021, Bucharest, Romania.|Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Ileana
authors.initials: I
authors.lastname: Peride
authors.affiliation: Department of Biostatistics and Biophysics, Faculty of Dental Medicine, "Ovidius" University Constanta, Constanta, Romania.
authors.forename: Lucian Cristian
authors.initials: LC
authors.lastname: Petcu
authors.affiliation: Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital Bucharest, 37th Dionisie Lupu StreetSector 2, 020021, Bucharest, Romania. niculaeandrei@yahoo.com.|Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy Bucharest, Bucharest, Romania. niculaeandrei@yahoo.com.
authors.forename: Andrei
authors.initials: A
authors.lastname: Niculae
authors.affiliation: Department of Nephrology, "Dr. C. I. Parhon" Clinical Hospital Iasi, Iasi, Romania.|Department of Internal Medicine I, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, Iasi, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.affiliation: Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital Bucharest, 37th Dionisie Lupu StreetSector 2, 020021, Bucharest, Romania.|Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
authors.forename: Ionel Alexandru
authors.initials: IA
authors.lastname: Checherita
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D060050:Angina, Stable / Q000150:complications / Q000000981:diagnostic imaging; D000789:Angina, Unstable / Q000150:complications / Q000000981:diagnostic imaging; D001639:Bicarbonates / Q000097:blood; D001851:Bone Diseases, Metabolic / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D002118:Calcium / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D010865:Pilot Projects; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D006435:Renal Dialysis; D018570:Risk Assessment / Q000379:methods; D012709:Serum Albumin / Q000378:metabolism; D061205:Vascular Calcification / Q000000981:diagnostic imaging
chemical_list: D001639:Bicarbonates; D010281:Parathyroid Hormone; D010710:Phosphates; D012709:Serum Albumin; D000469:Alkaline Phosphatase; D002118:Calcium
keywords: Chronic hemodialysis; Coronary angiography; Coronary risk score; Mineral bone disorder