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Prognostic value of cardiovascular calcifications in hemodialysis patients: a longitudinal study

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

Cardiovascular calcifications (CVC) are present in up to 70% of non-diabetic dialysis patients. Sparse data are available on predictors of very long-term outcomes of such patients. The Belgrade Aachen Study on Calcification in Hemodialysis patients (BASCH study) aimed to study this using a comprehensive CVC assessment.

Methods

We prospectively analyzed 220 hemodialysis patients followed for a mean of 76 months (median 73 months, range 6–160 months). We compared patients deceased from cardiovascular diseases (CVD) and survivors. Analyses included composite calcification scores (determined by combining ultrasound and X-ray analyses), demographic, clinical and laboratory data and pulse wave velocity (PWV). For survival analysis, patients were divided into group according to quartiles (Q).

Results

Compared to survivors, deceased patients from CVD were significantly older, more frequently hypertensive, had shorter dialysis times per week and lower Kt/V values, and they exhibited lower serum fetuin A, osteoprotegerin and hemoglobin as well as higher CRP levels. Composite calcification and Adragao scores were significantly higher in deceased patients from CVD as was PWV. Mean survival was 101 ± 47 months (Q1), 87 ± 51 month (Q2), 66 ± 48 (Q3) and 54 ± 45 months (Q4), p = 0.000. Cox multivariate regression analysis showed that independent predictors for cardiovascular mortality were composite calcification score in the range of third and fourth quartiles.

Conclusion

Composite calcification score emerged as significant predictors of long-term survival in our group of largely non-diabetic dialysis patient population, finding that should be confirmed by intervention studies.

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Authors and Affiliations

  1. School of Medicine, University of Belgrade, Belgrade, Serbia

    Nada Dimkovic

  2. Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, Belgrade, 11000, Serbia

    Nada Dimkovic, Aleksandar Jankovic, Zivka Djuric, Tatjana Damjanovic, Petar Djuric & Natasa Markovic

  3. Department of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany

    Georg Schlieper & Jürgen Floege

  4. Klinikum Coburg GmbH, Coburg, Germany

    Marcus Ketteler

  5. School of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia

    Jelena Marinkovic

  6. Laboratory for Statistics, Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia

    Zoran Radojcic

Authors
  1. Nada Dimkovic
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  2. Georg Schlieper
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  3. Aleksandar Jankovic
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  4. Zivka Djuric
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  5. Marcus Ketteler
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  11. Jürgen Floege
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Correspondence to Nada Dimkovic.

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Dimkovic, N., Schlieper, G., Jankovic, A. et al. Prognostic value of cardiovascular calcifications in hemodialysis patients: a longitudinal study. Int Urol Nephrol 50, 939–946 (2018). https://doi.org/10.1007/s11255-018-1821-1

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  • DOI: https://doi.org/10.1007/s11255-018-1821-1

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