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Hyperphosphatemia as an independent risk factor for coronary artery calcification progression in peritoneal dialysis patients.

Shang D, Xie Q, Ge X, Yan H, Tian J, Kuang D, Hao CM, Zhu T - BMC Nephrol (2015)

Bottom Line: Binary logistic regression was performed to identify the independent risk factors for CAC progression in the PD patients, and multivariate linear regression was conducted to identify factors associated with hyperphosphatemia.Multivariate linear regression revealed that hyperphosphatemia was associated with elevations in the transferrin and serum albumin levels and normalized protein catabolic rate (nPCR) and reductions in the hemoglobin level, residual Ccr, and PD Ccr.Hyperphosphatemia is an independent risk factor for CAC progression, and the serum phosphate level may be associated with protein intake and PD adequacy.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Huashan Hospital, Fudan University, 12 Wulumuqi Road (middle), Shanghai, 200040, China. sdshangda@163.com.

ABSTRACT

Background: Coronary artery calcification (CAC) is associated with cardiovascular mortality in end-stage renal disease (ESRD) patients. The present study aimed to identify modifiable risk factors for CAC progression in peritoneal dialysis (PD) patients.

Methods: Adult patients who received regular PD for more than 6 months and underwent a series of coronary artery calcification score (CaCS) measurements by multislice spiral computed tomography (MSCT) with an interval of ≥ 6 months were included in this observational cohort study. The demographic characteristics and clinical data, including laboratory data and adequacy of PD, were collected. Curve estimation was used to fit the straight line and obtain the slope. Binary logistic regression was performed to identify the independent risk factors for CAC progression in the PD patients, and multivariate linear regression was conducted to identify factors associated with hyperphosphatemia.

Results: A total of 207 adult patients on PD (116 men, 56.0 %) with a mean age of 59.8 ± 15.9 years were recruited to this study, and 157 of them (75.8 %) received three or more CaCS assessments. The patients were divided into a slow group (n = 137) and a rapid group (n = 70) according to the linear regression slope or the average speed of development. The follow-up time was 33.0 ± 18.8 months. Multivariate logistic regression revealed that age and serum phosphate level were independent risk factors for CAC progression after adjustments. Multivariate linear regression revealed that hyperphosphatemia was associated with elevations in the transferrin and serum albumin levels and normalized protein catabolic rate (nPCR) and reductions in the hemoglobin level, residual Ccr, and PD Ccr.

Conclusions: Hyperphosphatemia is an independent risk factor for CAC progression, and the serum phosphate level may be associated with protein intake and PD adequacy. These results provide important information for the clinical management of ESRD patients.

No MeSH data available.


Related in: MedlinePlus

The relationship between the interval and number of patients
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Fig1: The relationship between the interval and number of patients

Mentions: A total of 207 adult patients on PD (116 men, 56.0 %) with a mean age of 59.8 ± 15.9 years were recruited for this study. The follow-up time was 33.0 ± 18.8 months. A total of 70 patients started PD before initiation of the study (from 0.5 - 9 years prior). The average duration of PD therapy for all of the patients at baseline was 1.08 (−0.26 - 7.10) months, and there were no significant differences between the groups. Sixty-eight patients were followed for less than 2 years, 89 for more than 2 years but less than 4 years, and 50 for more than 4 years (Fig. 1). One hundred and fifty-seven (75.8 %) patients received ≥ 3 CaCS assessments, 116 (56 %) received ≥ 4 and 69 (33.3 %) had ≥ 5. In addition, 137 (66.2 %) patients received baseline CaCS examination from 1 month before PD to 6 months after PD. The basic CaCS was 0 for 84 (40.6 %) patients, 1 to 100 for 53 (25.6 %) patients, and ≥ 100 for 70 (33.8 %) patients.Fig. 1


Hyperphosphatemia as an independent risk factor for coronary artery calcification progression in peritoneal dialysis patients.

Shang D, Xie Q, Ge X, Yan H, Tian J, Kuang D, Hao CM, Zhu T - BMC Nephrol (2015)

The relationship between the interval and number of patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4506628&req=5

Fig1: The relationship between the interval and number of patients
Mentions: A total of 207 adult patients on PD (116 men, 56.0 %) with a mean age of 59.8 ± 15.9 years were recruited for this study. The follow-up time was 33.0 ± 18.8 months. A total of 70 patients started PD before initiation of the study (from 0.5 - 9 years prior). The average duration of PD therapy for all of the patients at baseline was 1.08 (−0.26 - 7.10) months, and there were no significant differences between the groups. Sixty-eight patients were followed for less than 2 years, 89 for more than 2 years but less than 4 years, and 50 for more than 4 years (Fig. 1). One hundred and fifty-seven (75.8 %) patients received ≥ 3 CaCS assessments, 116 (56 %) received ≥ 4 and 69 (33.3 %) had ≥ 5. In addition, 137 (66.2 %) patients received baseline CaCS examination from 1 month before PD to 6 months after PD. The basic CaCS was 0 for 84 (40.6 %) patients, 1 to 100 for 53 (25.6 %) patients, and ≥ 100 for 70 (33.8 %) patients.Fig. 1

Bottom Line: Binary logistic regression was performed to identify the independent risk factors for CAC progression in the PD patients, and multivariate linear regression was conducted to identify factors associated with hyperphosphatemia.Multivariate linear regression revealed that hyperphosphatemia was associated with elevations in the transferrin and serum albumin levels and normalized protein catabolic rate (nPCR) and reductions in the hemoglobin level, residual Ccr, and PD Ccr.Hyperphosphatemia is an independent risk factor for CAC progression, and the serum phosphate level may be associated with protein intake and PD adequacy.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Huashan Hospital, Fudan University, 12 Wulumuqi Road (middle), Shanghai, 200040, China. sdshangda@163.com.

ABSTRACT

Background: Coronary artery calcification (CAC) is associated with cardiovascular mortality in end-stage renal disease (ESRD) patients. The present study aimed to identify modifiable risk factors for CAC progression in peritoneal dialysis (PD) patients.

Methods: Adult patients who received regular PD for more than 6 months and underwent a series of coronary artery calcification score (CaCS) measurements by multislice spiral computed tomography (MSCT) with an interval of ≥ 6 months were included in this observational cohort study. The demographic characteristics and clinical data, including laboratory data and adequacy of PD, were collected. Curve estimation was used to fit the straight line and obtain the slope. Binary logistic regression was performed to identify the independent risk factors for CAC progression in the PD patients, and multivariate linear regression was conducted to identify factors associated with hyperphosphatemia.

Results: A total of 207 adult patients on PD (116 men, 56.0 %) with a mean age of 59.8 ± 15.9 years were recruited to this study, and 157 of them (75.8 %) received three or more CaCS assessments. The patients were divided into a slow group (n = 137) and a rapid group (n = 70) according to the linear regression slope or the average speed of development. The follow-up time was 33.0 ± 18.8 months. Multivariate logistic regression revealed that age and serum phosphate level were independent risk factors for CAC progression after adjustments. Multivariate linear regression revealed that hyperphosphatemia was associated with elevations in the transferrin and serum albumin levels and normalized protein catabolic rate (nPCR) and reductions in the hemoglobin level, residual Ccr, and PD Ccr.

Conclusions: Hyperphosphatemia is an independent risk factor for CAC progression, and the serum phosphate level may be associated with protein intake and PD adequacy. These results provide important information for the clinical management of ESRD patients.

No MeSH data available.


Related in: MedlinePlus