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Published in: Journal of Nephrology 1/2017

Open Access 01-02-2017 | Original Article

Abdominal aortic calcification in patients with CKD

Authors: Mieke J. Peeters, Jan AJG van den Brand, Arjan D. van Zuilen, Yelka Koster, Michiel L. Bots, Marc G. Vervloet, Peter J. Blankestijn, Jack FM Wetzels, For the MASTERPLAN Study Group

Published in: Journal of Nephrology | Issue 1/2017

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Abstract

Background

Abdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients.

Methods

We included patients with CKD not receiving renal replacement therapy from the MASTERPLAN study, a randomized controlled trial that started in 2004. In the period 2008–2009, an X-ray to evaluate AAC was performed in a subgroup of patients. We studied AAC using a semi-quantitative scoring system by lateral lumbar X-ray. We used baseline and 2-year data to find determinants of AAC. We used a composite cardiovascular endpoint and propensity score matching to evaluate the prognostic value of AAC.

Results

In 280 patients an X-ray was performed. In 79 patients (28 %) the X-ray showed no calcification, in 62 patients (22 %) calcification was minor (<4), while 139 patients (50 %) had moderate or heavy calcification (≥4). Older age, prior cardiovascular disease, higher triglyceride levels, and higher phosphate levels were independent determinants of a calcification score ≥4. AAC score ≥4 was independently associated with cardiovascular events, with a hazard ratio of 5.5 (95 % confidence interval 1.2–24.8).

Conclusions

Assessment of AAC can identify CKD patients at higher cardiovascular risk, and may provide important information for personalized treatment. Whether this approach will ultimately translate into better outcomes remains to be answered.
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Metadata
Title
Abdominal aortic calcification in patients with CKD
Authors
Mieke J. Peeters
Jan AJG van den Brand
Arjan D. van Zuilen
Yelka Koster
Michiel L. Bots
Marc G. Vervloet
Peter J. Blankestijn
Jack FM Wetzels
For the MASTERPLAN Study Group
Publication date
01-02-2017
Publisher
Springer International Publishing
Published in
Journal of Nephrology / Issue 1/2017
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI
https://doi.org/10.1007/s40620-015-0260-7

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