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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  ;  Seung Jun Kim  ;  Hyung Jung Oh  ;  Dong Eun Yoo  ;  Kwang Il Ko  ;  Hyang Mo Koo  ;  Chan Ho Kim  ;  Fa Mee Doh  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Kyu Hun Choi  ;  Shin-Wook Kang 
Citation
 PLOS ONE, Vol.7(11) : e48793, 2012 
Journal Title
 PLOS ONE 
Issue Date
2012
MeSH
Aged ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/pathology* ; Aortic Diseases/diagnostic imaging ; Aortic Diseases/epidemiology ; Aortic Diseases/pathology* ; Calcinosis/diagnostic imaging ; Calcinosis/epidemiology ; Calcinosis/pathology* ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis/mortality* ; Radiography ; Risk Factors ; Time Factors
Keywords
Aged ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/pathology* ; Aortic Diseases/diagnostic imaging ; Aortic Diseases/epidemiology ; Aortic Diseases/pathology* ; Calcinosis/diagnostic imaging ; Calcinosis/epidemiology ; Calcinosis/pathology* ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis/mortality* ; Radiography ; Risk Factors ; Time Factors
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.
Files in This Item:
T201203995.pdf Download
DOI
23144974
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Ko, Kwang Il(고광일)
Koo, Hyang Mo(구향모)
Kim, Seung Jun(김승준)
Kim, Chan Ho(김찬호)
Doh, Fa Mee(도화미) ORCID logo https://orcid.org/0000-0002-4780-6728
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Dong Eun(유동은)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91725
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