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Progression of aortic arch calcification over 1 year is an independent predictor of mortality in incident peritoneal dialysis patients

Title
Progression of aortic arch calcification over 1 year is an independent predictor of mortality in incident peritoneal dialysis patients
Authors
Mi Jung Lee;Dong Ho Shin;Shin-Wook Kang;Kyu Hun Choi;Tae-Hyun Yoo;Seung Hyeok Han;Jung Tak Park;Fa Mee Doh;Chan Ho Kim;Hyang Mo Koo;Kwang Il Ko;Dong Eun Yoo;Hyung Jung Oh;Seung Jun Kim
Issue Date
2012
Journal Title
PLoS One
ISSN
1932-6203
Citation
PLoS One, Vol.7(11) : e48793, 2012
Abstract
BACKGROUNDS AND AIMS: The presence and progression of vascular calcification have been demonstrated as important risk factors for mortality in dialysis patients. However, since the majority of subjects included in most previous studies were hemodialysis patients, limited information was available in peritoneal dialysis (PD) patients. Therefore, the aim of this study was to investigate the prevalence of aortic arch calcification (AoAC) and prognostic value of AoAC progression in PD patients. METHODS: We prospectively determined AoAC by chest X-ray at PD start and after 12 months, and evaluated the impact of AoAC progression on mortality in 415 incident PD patients. RESULTS: Of 415 patients, 169 patients (40.7%) had AoAC at baseline with a mean of 18.1±11.2%. The presence of baseline AoAC was an independent predictor of all-cause [Hazard ratio (HR): 2.181, 95% confidence interval (CI): 1.336-3.561, P = 0.002] and cardiovascular mortality (HR: 3.582, 95% CI: 1.577-8.132, P = 0.002). Among 363 patients with follow-up chest X-rays at 12 months after PD start, the proportion of patients with AoAC progression was significantly higher in patients with baseline AoAC (64.2 vs. 5.3%, P<0.001). Moreover, all-cause and cardiovascular death rates were significantly higher in the progression groups than in the non-progression group (P<0.001). Multivariate Cox analysis revealed that AoAC progression was an independent predictor for all-cause (HR: 2.625, 95% CI: 1.150-5.991, P = 0.022) and cardiovascular mortality (HR: 4.008, 95% CI: 1.079-14.890, P = 0.038) in patients with AoAC at baseline. CONCLUSIONS: The presence and progression of AoAC assessed by chest X-ray were independently associated with unfavorable outcomes in incident PD patients. Regular follow-up by chest X-ray could be a simple and useful method to stratify mortality risk in these patients.
URI

http://ir.ymlib.yonsei.ac.kr/handle/22282913/91725
DOI
10.1371/journal.pone.0048793
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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