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Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries.

Abstract

BACKGROUND

The objective of the study was to determine the relationship between common carotid artery intima-media thickness (CCA-IMT) and histologically assessed calcification of radial artery in relation to clinical features and laboratory markers of bone and mineral metabolism, inflammation, and oxidative stress in patients with stage 5 chronic kidney disease (CKD).

METHODS

The study comprised 59 patients (36 hemodialyzed, 23 predialysis). CCA-IMT was measured by ultrasonography; the biochemical parameters examined were assessed using routine laboratory methods, ELISA micro-plate immunoassays and spectrophotometry. Fragments of radial artery obtained during creation of hemodialysis access were cryosectioned and stained for calcifications using von Kossa method and alizarin red.

RESULTS

Glucose, osteoprotegerin, pentraxin 3 and Framingham risk score significantly correlated with CCA-IMT. In multiple regression analysis, OPG positively predicted CCA-IMT. Radial artery calcifications were found in 34 patients who showed higher CCA-IMT (0.98 ± 0.13 vs 0.86 ± 0.14 mm; P = 0.006). Higher CCA-IMT values were also associated with more advanced calcifications. CCA-IMT and the presence of plaques in common carotid artery were positive predictors of radial artery calcifications, independent of dialysis status, Framingham risk score, CRP and Ca x Pi [OR for calcifications 2.19 (1.08-4.45) per 0.1 mm increase in CCA-IMT]. The presence of radial artery calcifications was a significant predictor of mortality, independent of dialysis status and Framingham risk score [HR 3.16 (1.03-9.64)].

CONCLUSIONS

In CKD patients, CCA-IMT examination can be used as a surrogate measure to assess the incidence and severity of arterial medial calcification which is associated with poor clinical outcome in these patients.

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  • Authors+Show Affiliations

    ,

    Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. kasiajanda@op.pl.

    ,

    Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. mkrzanowski@op.pl.

    ,

    Chair and Department of Histology, Jagiellonian University, Medical College, Cracow, Poland. mmgajda@cyf-kr.edu.pl.

    ,

    Department of Medical Diagnostics, Jagiellonian University, Medical College, Cracow, Poland. paulina.dumnicka@uj.edu.pl.

    ,

    Chair of Clinical Biochemistry, Jagiellonian University, Medical College, Cracow, Poland. danuta.fedak@uj.edu.pl.

    ,

    Chair and Department of Histology, Jagiellonian University, Medical College, Cracow, Poland. mmlis@cyf-kr.edu.pl.

    ,

    Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. jaskowskip@interia.pl.

    ,

    Radioligand Laboratory, Faculty of Pharmacy, Jagiellonian University, Medical College, Cracow, Poland. apietrzy1@cm-uj.krakow.pl.

    ,

    Chair and Department of Histology, Jagiellonian University, Medical College, Cracow, Poland. mmlitwin@cyf-kr.edu.pl.

    Chair and Department of Nephrology, Jagiellonian University, Medical College, Kopernika 15c, 31-501, Cracow, Poland. wladsul@mp.pl.

    Source

    BMC nephrology 16: 2015 Jun 03 pg 78

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Blood Glucose
    C-Reactive Protein
    Cardiovascular Diseases
    Carotid Artery, Common
    Carotid Intima-Media Thickness
    Cohort Studies
    Coronary Artery Disease
    Fibroblast Growth Factors
    Humans
    Incidence
    Inflammation
    Insulin Resistance
    Interleukin-6
    Kidney Failure, Chronic
    Logistic Models
    Middle Aged
    Multivariate Analysis
    Osteocalcin
    Osteopontin
    Osteoprotegerin
    Oxidative Stress
    Radial Artery
    Renal Dialysis
    Renal Insufficiency, Chronic
    Risk Assessment
    Serum Amyloid P-Component
    Severity of Illness Index
    Tunica Media
    Vascular Calcification
    alpha-2-HS-Glycoprotein

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26037625

    Citation

    Janda, Katarzyna, et al. "Cardiovascular Risk in Chronic Kidney Disease Patients: Intima-media Thickness Predicts the Incidence and Severity of Histologically Assessed Medial Calcification in Radial Arteries." BMC Nephrology, vol. 16, 2015, p. 78.
    Janda K, Krzanowski M, Gajda M, et al. Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries. BMC Nephrol. 2015;16:78.
    Janda, K., Krzanowski, M., Gajda, M., Dumnicka, P., Fedak, D., Lis, G. J., ... Sułowicz, W. (2015). Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries. BMC Nephrology, 16, p. 78. doi:10.1186/s12882-015-0067-8.
    Janda K, et al. Cardiovascular Risk in Chronic Kidney Disease Patients: Intima-media Thickness Predicts the Incidence and Severity of Histologically Assessed Medial Calcification in Radial Arteries. BMC Nephrol. 2015 Jun 3;16:78. PubMed PMID: 26037625.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries. AU - Janda,Katarzyna, AU - Krzanowski,Marcin, AU - Gajda,Mariusz, AU - Dumnicka,Paulina, AU - Fedak,Danuta, AU - Lis,Grzegorz J, AU - Jaśkowski,Piotr, AU - Pietrzycka,Agata, AU - Litwin,Jan A, AU - Sułowicz,Władysław, Y1 - 2015/06/03/ PY - 2015/01/24/received PY - 2015/05/20/accepted PY - 2015/6/4/entrez PY - 2015/6/4/pubmed PY - 2016/1/27/medline SP - 78 EP - 78 JF - BMC nephrology JO - BMC Nephrol VL - 16 N2 - BACKGROUND: The objective of the study was to determine the relationship between common carotid artery intima-media thickness (CCA-IMT) and histologically assessed calcification of radial artery in relation to clinical features and laboratory markers of bone and mineral metabolism, inflammation, and oxidative stress in patients with stage 5 chronic kidney disease (CKD). METHODS: The study comprised 59 patients (36 hemodialyzed, 23 predialysis). CCA-IMT was measured by ultrasonography; the biochemical parameters examined were assessed using routine laboratory methods, ELISA micro-plate immunoassays and spectrophotometry. Fragments of radial artery obtained during creation of hemodialysis access were cryosectioned and stained for calcifications using von Kossa method and alizarin red. RESULTS: Glucose, osteoprotegerin, pentraxin 3 and Framingham risk score significantly correlated with CCA-IMT. In multiple regression analysis, OPG positively predicted CCA-IMT. Radial artery calcifications were found in 34 patients who showed higher CCA-IMT (0.98 ± 0.13 vs 0.86 ± 0.14 mm; P = 0.006). Higher CCA-IMT values were also associated with more advanced calcifications. CCA-IMT and the presence of plaques in common carotid artery were positive predictors of radial artery calcifications, independent of dialysis status, Framingham risk score, CRP and Ca x Pi [OR for calcifications 2.19 (1.08-4.45) per 0.1 mm increase in CCA-IMT]. The presence of radial artery calcifications was a significant predictor of mortality, independent of dialysis status and Framingham risk score [HR 3.16 (1.03-9.64)]. CONCLUSIONS: In CKD patients, CCA-IMT examination can be used as a surrogate measure to assess the incidence and severity of arterial medial calcification which is associated with poor clinical outcome in these patients. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/26037625/Cardiovascular_risk_in_chronic_kidney_disease_patients:_intima_media_thickness_predicts_the_incidence_and_severity_of_histologically_assessed_medial_calcification_in_radial_arteries_ L2 - https://www.biomedcentral.com/1471-2369/16/78 DB - PRIME DP - Unbound Medicine ER -