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

Nada Dimkovic1,2, Georg Schlieper3, Aleksandar Jankovic4

  • 1School of Medicine, University of Belgrade, Belgrade, Serbia. dim@eunet.rs.

International Urology and Nephrology
|February 15, 2018
PubMed

Insights

Cardiovascular calcifications predict long-term survival in hemodialysis patients. Higher composite calcification scores are linked to increased cardiovascular mortality, highlighting their importance in patient outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Cardiovascular calcifications (CVC) affect up to 70% of non-diabetic dialysis patients.
  • Data on long-term outcome predictors for these patients are limited.
  • The Belgrade Aachen Study on Calcification in Hemodialysis patients (BASCH study) investigated this using comprehensive CVC assessment.

Purpose of the Study:

  • To identify predictors of very long-term outcomes in hemodialysis patients.
  • To assess the role of cardiovascular calcifications in long-term survival.
  • To analyze demographic, clinical, laboratory data, and pulse wave velocity (PWV) in relation to outcomes.

Main Methods:

  • Prospective analysis of 220 hemodialysis patients with a mean follow-up of 76 months.
  • Comparison of patients deceased from cardiovascular diseases (CVD) versus survivors.
  • Inclusion of composite calcification scores (ultrasound and X-ray), clinical data, laboratory values, and PWV.

Main Results:

  • Deceased patients were older, more hypertensive, had shorter dialysis times, lower Kt/V, lower serum fetuin A, osteoprotegerin, hemoglobin, and higher CRP levels.
  • Composite calcification scores, Adragao scores, and PWV were significantly higher in patients deceased from CVD.
  • Independent predictors for cardiovascular mortality included composite calcification scores in the third and fourth quartiles.

Conclusions:

  • Composite calcification score is a significant predictor of long-term survival in non-diabetic dialysis patients.
  • These findings require confirmation through intervention studies.
  • Comprehensive CVC assessment is crucial for predicting outcomes in hemodialysis patients.
Abstract

Keywords:
Calcification inhibitorsCalcification promotersCardiovascular calcificationsHemodialysisLong-term survival

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