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A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
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Vascular Calcification Progression Modulates the Risk Associated with Vascular Calcification Burden in Incident to
Antonio Bellasi1, Luca Di Lullo2, Domenico Russo3
1Department of Medicine, Division of Nephrology, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.
Cells
|June 2, 2021
Summary
Coronary artery calcification (CAC) progression predicts mortality in new hemodialysis patients. However, progression may reduce baseline CAC risk, and calcium-free binders may improve survival.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Chronic kidney disease (CKD) causes millions of deaths annually, primarily from cardiovascular (CV) diseases.
- Vascular calcification is a key non-traditional CV risk factor in CKD patients.
- Patients initiating hemodialysis (HD) face a high mortality risk, necessitating investigation of predictive factors.
Purpose of the Study:
- To investigate the association between coronary artery calcification (CAC) progression and all-cause mortality in patients new to hemodialysis.
- To explore the interplay between baseline CAC burden, CAC progression (CACP), and mortality risk.
- To assess the impact of calcium-free phosphate binders on the CACP-mortality relationship.
Main Methods:
- Post hoc analysis of the Independent study (NCT00710788).
- Computed tomography imaging for CAC quantification at baseline and 12 months in 414 incident HD patients.
- Survival analysis to evaluate associations of CAC burden, CACP, and mortality over a median 36-month follow-up.
Main Results:
- 106 deaths occurred during follow-up; older, diabetic patients with prior CV events had higher CAC burden.
- Both baseline CAC burden (HR: 1.29) and CACP (HR: 5.16) were independently associated with all-cause mortality.
- CACP mitigated the risk of baseline CAC burden (p=0.002); calcium-free phosphate binders attenuated the CACP-mortality link.
Conclusions:
- CAC burden and CACP are significant predictors of mortality in incident HD patients.
- CACP may paradoxically reduce the risk associated with baseline CAC, and its association with mortality is attenuated by calcium-free phosphate binders.
- Modulating CACP through interventions like specific medications or kidney transplantation may improve survival in this high-risk population.
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