Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study
Abstract Background Abdominal aortic calcification assessed by X-ray is recommended to evaluate vascular calcification in dialysis patients. It has been shown that abdominal aortic calcification score (AACS) is a predictor of adverse outcomes in hemodialysis patients, but evidence regarding its prog...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-020-01822-9 |
| _version_ | 1811214889007448064 |
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| author | Dahua Ma Hao Yan Xiaoxiao Yang Zanzhe Yu Zhaohui Ni Wei Fang |
| author_facet | Dahua Ma Hao Yan Xiaoxiao Yang Zanzhe Yu Zhaohui Ni Wei Fang |
| author_sort | Dahua Ma |
| collection | DOAJ |
| description | Abstract Background Abdominal aortic calcification assessed by X-ray is recommended to evaluate vascular calcification in dialysis patients. It has been shown that abdominal aortic calcification score (AACS) is a predictor of adverse outcomes in hemodialysis patients, but evidence regarding its prognostic value in peritoneal dialysis (PD) patients is still insufficient. We aimed to examine the predictive role of AACS for major adverse cardiac and cerebrovascular events (MACCE) and mortality in PD patients. Methods Eligible patients undergoing PD between July 2011 and July 2014 were recruited. AACS was quantified using lateral lumbar radiography at recruitment. Patients were prospectively followed up until death, PD cessation, or to the end of the study (August 31, 2018). Both subdistribution hazards and cause-specific hazards models were used to evaluate the association between AACS and MACCE as well as mortality. Results 292 patients were enrolled, including 160 males (54.8%) with mean age 57.1 ± 15.2 years and median PD duration 28.4 (IQR 12.0, 57.8) months. Among them, 75 (25.7%) patients were comorbid with diabetes, and 94 (32.2%) patients had cardiovascular disease (CVD). The average AACS was 2.0 (0.0, 6.0). Patients were categorized on the tertiles of AACS (Low AACS group, AACS = 0, n = 125; Medium AACS group, AACS 1–4, n = 72; and High AACS group, AACS> 4, n = 95). AACS was associated with age (OR = 1.081, P < 0.001), PD duration (OR = 1.012, P = 0.003), CVD (OR = 1.919, P = 0.020) and diabetes (OR = 2.554, P = 0.002). During the follow-up period of 43.6 (24.6, 50.7) months, there were 65 MACCEs and 84 deaths. Significantly higher cumulative incidences of all-cause mortality (Log-rank = 35.992, P<0.001; Gray = 38.662, P < 0.001) and MACCE (Log-rank = 26.146, P<0.001; Gray = 27.810, P < 0.001) were observed in the upper AACS tertile. AACS was an independent predictor of all-cause mortality (HR = 2.438, 95% CI 1.246–4.772, P = 0.009; SHR = 2.323, 95%CI 1.229–4.389, P = 0.009) and MACCE (HR = 3.455, 95% CI 1.734–6.884, P < 0.001; SHR = 3.063, 95%CI 1.460–6.430, P = 0.003) in this study. Conclusions AACS was associated with age, PD duration, CVD and diabetes in PD patients. AACS could predict MACCE and all-cause mortality in this population. It thus might be a safe and feasible method to identify PD patients with adverse outcomes. |
| first_indexed | 2024-04-12T06:13:03Z |
| format | Article |
| id | doaj.art-a95ae66cb21d4fc0b81b0141ee5affd2 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-12T06:13:03Z |
| publishDate | 2020-04-01 |
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| series | BMC Nephrology |
| spelling | doaj.art-a95ae66cb21d4fc0b81b0141ee5affd22022-12-22T03:44:39ZengBMCBMC Nephrology1471-23692020-04-0121111010.1186/s12882-020-01822-9Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort studyDahua Ma0Hao Yan1Xiaoxiao Yang2Zanzhe Yu3Zhaohui Ni4Wei Fang5Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityAbstract Background Abdominal aortic calcification assessed by X-ray is recommended to evaluate vascular calcification in dialysis patients. It has been shown that abdominal aortic calcification score (AACS) is a predictor of adverse outcomes in hemodialysis patients, but evidence regarding its prognostic value in peritoneal dialysis (PD) patients is still insufficient. We aimed to examine the predictive role of AACS for major adverse cardiac and cerebrovascular events (MACCE) and mortality in PD patients. Methods Eligible patients undergoing PD between July 2011 and July 2014 were recruited. AACS was quantified using lateral lumbar radiography at recruitment. Patients were prospectively followed up until death, PD cessation, or to the end of the study (August 31, 2018). Both subdistribution hazards and cause-specific hazards models were used to evaluate the association between AACS and MACCE as well as mortality. Results 292 patients were enrolled, including 160 males (54.8%) with mean age 57.1 ± 15.2 years and median PD duration 28.4 (IQR 12.0, 57.8) months. Among them, 75 (25.7%) patients were comorbid with diabetes, and 94 (32.2%) patients had cardiovascular disease (CVD). The average AACS was 2.0 (0.0, 6.0). Patients were categorized on the tertiles of AACS (Low AACS group, AACS = 0, n = 125; Medium AACS group, AACS 1–4, n = 72; and High AACS group, AACS> 4, n = 95). AACS was associated with age (OR = 1.081, P < 0.001), PD duration (OR = 1.012, P = 0.003), CVD (OR = 1.919, P = 0.020) and diabetes (OR = 2.554, P = 0.002). During the follow-up period of 43.6 (24.6, 50.7) months, there were 65 MACCEs and 84 deaths. Significantly higher cumulative incidences of all-cause mortality (Log-rank = 35.992, P<0.001; Gray = 38.662, P < 0.001) and MACCE (Log-rank = 26.146, P<0.001; Gray = 27.810, P < 0.001) were observed in the upper AACS tertile. AACS was an independent predictor of all-cause mortality (HR = 2.438, 95% CI 1.246–4.772, P = 0.009; SHR = 2.323, 95%CI 1.229–4.389, P = 0.009) and MACCE (HR = 3.455, 95% CI 1.734–6.884, P < 0.001; SHR = 3.063, 95%CI 1.460–6.430, P = 0.003) in this study. Conclusions AACS was associated with age, PD duration, CVD and diabetes in PD patients. AACS could predict MACCE and all-cause mortality in this population. It thus might be a safe and feasible method to identify PD patients with adverse outcomes.http://link.springer.com/article/10.1186/s12882-020-01822-9Abdominal aortic calcification scoreMajor adverse cardiovascular and cerebrovascular eventsAll-cause mortalityPeritoneal dialysis |
| spellingShingle | Dahua Ma Hao Yan Xiaoxiao Yang Zanzhe Yu Zhaohui Ni Wei Fang Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study BMC Nephrology Abdominal aortic calcification score Major adverse cardiovascular and cerebrovascular events All-cause mortality Peritoneal dialysis |
| title | Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study |
| title_full | Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study |
| title_fullStr | Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study |
| title_full_unstemmed | Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study |
| title_short | Abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients: a prospective cohort study |
| title_sort | abdominal aortic calcification score as a predictor of clinical outcome in peritoneal dialysis patients a prospective cohort study |
| topic | Abdominal aortic calcification score Major adverse cardiovascular and cerebrovascular events All-cause mortality Peritoneal dialysis |
| url | http://link.springer.com/article/10.1186/s12882-020-01822-9 |
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