Impact of Cardiovascular Calcification in Nondialyzed Patients after 24 Months of Follow-up

Impact of Cardiovascular Calcification in Nondialyzed Patients after 24 Months of Follow-up

Author Watanabe, Renato Autor UNIFESP Google Scholar
Lemos, Marcelo Montebello Autor UNIFESP Google Scholar
Manfredi, Silvia Regina Autor UNIFESP Google Scholar
Draibe, Sergio Aron Autor UNIFESP Google Scholar
Canziani, Maria Eugenia Fernandes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background and objectives: Coronary artery calcification (CAC) is highly prevalent among patients with chronic kidney disease (CKD), and it has been described as a strong predictor of mortality in the dialysis population. Because there is a lack of information regarding cardiovascular calcification and clinical outcomes in the earlier stages of the disease, we aimed to evaluate the impact of CAC on cardiovascular events, hospitalization, and mortality in nondialyzed patients with CKD.Design, setting, participants, & measurements: This is a prospective study including 117 nondialyzed patients with CKD (age, 57 +/- 11.2 years; 61% male; 23% diabetics; creatinine clearance, 36.6 +/- 17.8 ml/min per 1.73 m(2)). CAC was quantified by multislice computed tomography. the occurrence of cardiovascular events, hospitalization, and death was recorded over 24 months.Results: CAC >10 Agatston units (AU) was observed in 48% of the patients [334 (108 to 858.5) AU; median (interquartiles)], and calcification score >= 400 AU was found in 21% [873 (436-2500) AU]. During the follow-up, the occurrence of 15 cardiovascular events, 19 hospitalizations, and 4 deaths was registered. the presence of CAC >10 AU was associated with shorter hospitalization event-free time and lower survival. CAC 2:400 AU was additionally associated with shorter cardiovascular event-free time. Adjusting for age and diabetes, CAC 2:400 AU was independently associated with the occurrence of hospitalization and cardiovascular events.Conclusions: Cardiovascular events, hospitalization, and mortality were associated with the presence of CAC in nondialyzed patients with CKD. Severe CAC was a predictor of cardiovascular events and hospitalization in these patients. Clin J Am Soc Nephrol 5: 189-194, 2010. doi: 10.2215/CJN.06240909
Language English
Date 2010-02-01
Published in Clinical Journal of the American Society of Nephrology. Washington: Amer Soc Nephrology, v. 5, n. 2, p. 189-194, 2010.
ISSN 1555-9041 (Sherpa/Romeo, impact factor)
Publisher Amer Soc Nephrology
Extent 189-194
Origin http://dx.doi.org/10.2215/CJN.06240909
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000274703400005
URI http://repositorio.unifesp.br/handle/11600/32198

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