Vascular calcification in patients with nondialysis CKD over 3 years
Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed. The Study of Mineral and Bone Disorders in CKD in Spain...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2015-04, Vol.10 (4), p.654-666 |
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| creator | Górriz, José L Molina, Pablo Cerverón, M Jesús Vila, Rocío Bover, Jordi Nieto, Javier Barril, Guillermina Martínez-Castelao, Alberto Fernández, Elvira Escudero, Verónica Piñera, Celestino Adragao, Teresa Navarro-Gonzalez, Juan F Molinero, Luis M Castro-Alonso, Cristina Pallardó, Luis M Jamal, Sophie A |
| description | Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed.
The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3-5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models.
VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P |
| doi_str_mv | 10.2215/CJN.07450714 |
| format | Article |
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The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3-5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models.
VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P<0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P<0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS≥3. After a median follow-up of 35 months (interquartile range=17-36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS≥3 but not KS>6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event-free period (HR, 1.14; 95% CI, 1.06 to 1.22; P<0.001). VC did not predict renal progression.
VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful index to identify patients with CKD at high risk of death and morbidity as previously reported in patients on dialysis.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.07450714</identifier><identifier>PMID: 25770175</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Aged ; Chi-Square Distribution ; Disease Progression ; Disease-Free Survival ; Female ; Glomerular Filtration Rate ; Hospitalization ; Humans ; Kaplan-Meier Estimate ; Kidney - physiopathology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Original ; Predictive Value of Tests ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Renal Dialysis ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - mortality ; Renal Insufficiency, Chronic - therapy ; Risk Assessment ; Risk Factors ; Spain - epidemiology ; Time Factors ; Vascular Calcification - diagnosis ; Vascular Calcification - epidemiology ; Vascular Calcification - mortality ; Vascular Calcification - therapy</subject><ispartof>Clinical journal of the American Society of Nephrology, 2015-04, Vol.10 (4), p.654-666</ispartof><rights>Copyright © 2015 by the American Society of Nephrology.</rights><rights>Copyright © 2015 by the American Society of Nephrology 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-7f47588732009270c325153c71728f030b8cc804f21d5e7f7c82db5b72343c6c3</citedby><cites>FETCH-LOGICAL-c384t-7f47588732009270c325153c71728f030b8cc804f21d5e7f7c82db5b72343c6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386255/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386255/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25770175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Górriz, José L</creatorcontrib><creatorcontrib>Molina, Pablo</creatorcontrib><creatorcontrib>Cerverón, M Jesús</creatorcontrib><creatorcontrib>Vila, Rocío</creatorcontrib><creatorcontrib>Bover, Jordi</creatorcontrib><creatorcontrib>Nieto, Javier</creatorcontrib><creatorcontrib>Barril, Guillermina</creatorcontrib><creatorcontrib>Martínez-Castelao, Alberto</creatorcontrib><creatorcontrib>Fernández, Elvira</creatorcontrib><creatorcontrib>Escudero, Verónica</creatorcontrib><creatorcontrib>Piñera, Celestino</creatorcontrib><creatorcontrib>Adragao, Teresa</creatorcontrib><creatorcontrib>Navarro-Gonzalez, Juan F</creatorcontrib><creatorcontrib>Molinero, Luis M</creatorcontrib><creatorcontrib>Castro-Alonso, Cristina</creatorcontrib><creatorcontrib>Pallardó, Luis M</creatorcontrib><creatorcontrib>Jamal, Sophie A</creatorcontrib><title>Vascular calcification in patients with nondialysis CKD over 3 years</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed.
The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3-5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models.
VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P<0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P<0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS≥3. After a median follow-up of 35 months (interquartile range=17-36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS≥3 but not KS>6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event-free period (HR, 1.14; 95% CI, 1.06 to 1.22; P<0.001). VC did not predict renal progression.
VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful index to identify patients with CKD at high risk of death and morbidity as previously reported in patients on dialysis.</description><subject>Aged</subject><subject>Chi-Square Distribution</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney - physiopathology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Renal Dialysis</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - mortality</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Spain - epidemiology</subject><subject>Time Factors</subject><subject>Vascular Calcification - diagnosis</subject><subject>Vascular Calcification - epidemiology</subject><subject>Vascular Calcification - mortality</subject><subject>Vascular Calcification - therapy</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1LAzEYhIMotlZvniVHD27NZ5NeBNn6XfSi4i1ks1kbSTc12a3037vSWvT0DrzDzPAAcIzRkBDMz_P7xyESjCOB2Q7oY855Nkb8bXerGe6Bg5Q-EGKMEr4PeoQLgbDgfTB51cm0XkdotDeuckY3LtTQ1XDRKVs3CX65ZgbrUJdO-1VyCeYPExiWNkIKV1bHdAj2Ku2TPdrcAXi5vnrOb7Pp081dfjnNDJWsyUTFBJdSUILQmAhkujGYUyOwILJCFBXSGIlYRXDJraiEkaQseCEIZdSMDB2Ai3Xuoi3mtjTduqi9WkQ313Glgnbq_6d2M_UelopROSKcdwGnm4AYPlubGjV3yVjvdW1DmxQeCYLGjHaNA3C2tpoYUoq22tZgpH7Aqw68-gXf2U_-Ttuaf0nTb1x2fT8</recordid><startdate>20150407</startdate><enddate>20150407</enddate><creator>Górriz, José L</creator><creator>Molina, Pablo</creator><creator>Cerverón, M Jesús</creator><creator>Vila, Rocío</creator><creator>Bover, Jordi</creator><creator>Nieto, Javier</creator><creator>Barril, Guillermina</creator><creator>Martínez-Castelao, Alberto</creator><creator>Fernández, Elvira</creator><creator>Escudero, Verónica</creator><creator>Piñera, Celestino</creator><creator>Adragao, Teresa</creator><creator>Navarro-Gonzalez, Juan F</creator><creator>Molinero, Luis M</creator><creator>Castro-Alonso, Cristina</creator><creator>Pallardó, Luis M</creator><creator>Jamal, Sophie A</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150407</creationdate><title>Vascular calcification in patients with nondialysis CKD over 3 years</title><author>Górriz, José L ; Molina, Pablo ; Cerverón, M Jesús ; Vila, Rocío ; Bover, Jordi ; Nieto, Javier ; Barril, Guillermina ; Martínez-Castelao, Alberto ; Fernández, Elvira ; Escudero, Verónica ; Piñera, Celestino ; Adragao, Teresa ; Navarro-Gonzalez, Juan F ; Molinero, Luis M ; Castro-Alonso, Cristina ; Pallardó, Luis M ; Jamal, Sophie A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-7f47588732009270c325153c71728f030b8cc804f21d5e7f7c82db5b72343c6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Chi-Square Distribution</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney - physiopathology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Renal Dialysis</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - mortality</topic><topic>Renal Insufficiency, Chronic - therapy</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Spain - epidemiology</topic><topic>Time Factors</topic><topic>Vascular Calcification - diagnosis</topic><topic>Vascular Calcification - epidemiology</topic><topic>Vascular Calcification - mortality</topic><topic>Vascular Calcification - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Górriz, José L</creatorcontrib><creatorcontrib>Molina, Pablo</creatorcontrib><creatorcontrib>Cerverón, M Jesús</creatorcontrib><creatorcontrib>Vila, Rocío</creatorcontrib><creatorcontrib>Bover, Jordi</creatorcontrib><creatorcontrib>Nieto, Javier</creatorcontrib><creatorcontrib>Barril, Guillermina</creatorcontrib><creatorcontrib>Martínez-Castelao, Alberto</creatorcontrib><creatorcontrib>Fernández, Elvira</creatorcontrib><creatorcontrib>Escudero, Verónica</creatorcontrib><creatorcontrib>Piñera, Celestino</creatorcontrib><creatorcontrib>Adragao, Teresa</creatorcontrib><creatorcontrib>Navarro-Gonzalez, Juan F</creatorcontrib><creatorcontrib>Molinero, Luis M</creatorcontrib><creatorcontrib>Castro-Alonso, Cristina</creatorcontrib><creatorcontrib>Pallardó, Luis M</creatorcontrib><creatorcontrib>Jamal, Sophie A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Górriz, José L</au><au>Molina, Pablo</au><au>Cerverón, M Jesús</au><au>Vila, Rocío</au><au>Bover, Jordi</au><au>Nieto, Javier</au><au>Barril, Guillermina</au><au>Martínez-Castelao, Alberto</au><au>Fernández, Elvira</au><au>Escudero, Verónica</au><au>Piñera, Celestino</au><au>Adragao, Teresa</au><au>Navarro-Gonzalez, Juan F</au><au>Molinero, Luis M</au><au>Castro-Alonso, Cristina</au><au>Pallardó, Luis M</au><au>Jamal, Sophie A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascular calcification in patients with nondialysis CKD over 3 years</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2015-04-07</date><risdate>2015</risdate><volume>10</volume><issue>4</issue><spage>654</spage><epage>666</epage><pages>654-666</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed.
The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3-5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models.
VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P<0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P<0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS≥3. After a median follow-up of 35 months (interquartile range=17-36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS≥3 but not KS>6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event-free period (HR, 1.14; 95% CI, 1.06 to 1.22; P<0.001). VC did not predict renal progression.
VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful index to identify patients with CKD at high risk of death and morbidity as previously reported in patients on dialysis.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>25770175</pmid><doi>10.2215/CJN.07450714</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Chi-Square Distribution Disease Progression Disease-Free Survival Female Glomerular Filtration Rate Hospitalization Humans Kaplan-Meier Estimate Kidney - physiopathology Logistic Models Male Middle Aged Multivariate Analysis Odds Ratio Original Predictive Value of Tests Prevalence Proportional Hazards Models Prospective Studies Renal Dialysis Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - mortality Renal Insufficiency, Chronic - therapy Risk Assessment Risk Factors Spain - epidemiology Time Factors Vascular Calcification - diagnosis Vascular Calcification - epidemiology Vascular Calcification - mortality Vascular Calcification - therapy |
| title | Vascular calcification in patients with nondialysis CKD over 3 years |
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