Abdominal aortic calcification in patients with CKD

Mieke J Peeters, Jan Ajg van den Brand, Arjan D van Zuilen, Yelka Koster, Michiel L Bots, Marc G Vervloet, Peter J Blankestijn, Jack Fm Wetzels, MASTERPLAN Study Group

Research output: Contribution to journalArticleProfessional

Abstract

BACKGROUND: Abdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients.

METHODS: We included patients with CKD not receiving renal replacement therapy from the MASTERPLAN study, a randomized controlled trial that started in 2004. In the period 2008-2009, an X-ray to evaluate AAC was performed in a subgroup of patients. We studied AAC using a semi-quantitative scoring system by lateral lumbar X-ray. We used baseline and 2-year data to find determinants of AAC. We used a composite cardiovascular endpoint and propensity score matching to evaluate the prognostic value of AAC.

RESULTS: In 280 patients an X-ray was performed. In 79 patients (28 %) the X-ray showed no calcification, in 62 patients (22 %) calcification was minor (<4), while 139 patients (50 %) had moderate or heavy calcification (≥4). Older age, prior cardiovascular disease, higher triglyceride levels, and higher phosphate levels were independent determinants of a calcification score ≥4. AAC score ≥4 was independently associated with cardiovascular events, with a hazard ratio of 5.5 (95 % confidence interval 1.2-24.8).

CONCLUSIONS: Assessment of AAC can identify CKD patients at higher cardiovascular risk, and may provide important information for personalized treatment. Whether this approach will ultimately translate into better outcomes remains to be answered.

Original languageEnglish
Pages (from-to)109-118
Number of pages10
JournalJournal of Nephrology
Volume30
Issue number1
DOIs
Publication statusPublished - Feb 2017

Cite this

Peeters, M. J., van den Brand, J. A., van Zuilen, A. D., Koster, Y., Bots, M. L., Vervloet, M. G., ... MASTERPLAN Study Group (2017). Abdominal aortic calcification in patients with CKD. Journal of Nephrology, 30(1), 109-118. https://doi.org/10.1007/s40620-015-0260-7
Peeters, Mieke J ; van den Brand, Jan Ajg ; van Zuilen, Arjan D ; Koster, Yelka ; Bots, Michiel L ; Vervloet, Marc G ; Blankestijn, Peter J ; Wetzels, Jack Fm ; MASTERPLAN Study Group. / Abdominal aortic calcification in patients with CKD. In: Journal of Nephrology. 2017 ; Vol. 30, No. 1. pp. 109-118.
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abstract = "BACKGROUND: Abdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients.METHODS: We included patients with CKD not receiving renal replacement therapy from the MASTERPLAN study, a randomized controlled trial that started in 2004. In the period 2008-2009, an X-ray to evaluate AAC was performed in a subgroup of patients. We studied AAC using a semi-quantitative scoring system by lateral lumbar X-ray. We used baseline and 2-year data to find determinants of AAC. We used a composite cardiovascular endpoint and propensity score matching to evaluate the prognostic value of AAC.RESULTS: In 280 patients an X-ray was performed. In 79 patients (28 {\%}) the X-ray showed no calcification, in 62 patients (22 {\%}) calcification was minor (<4), while 139 patients (50 {\%}) had moderate or heavy calcification (≥4). Older age, prior cardiovascular disease, higher triglyceride levels, and higher phosphate levels were independent determinants of a calcification score ≥4. AAC score ≥4 was independently associated with cardiovascular events, with a hazard ratio of 5.5 (95 {\%} confidence interval 1.2-24.8).CONCLUSIONS: Assessment of AAC can identify CKD patients at higher cardiovascular risk, and may provide important information for personalized treatment. Whether this approach will ultimately translate into better outcomes remains to be answered.",
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Peeters, MJ, van den Brand, JA, van Zuilen, AD, Koster, Y, Bots, ML, Vervloet, MG, Blankestijn, PJ, Wetzels, JF & MASTERPLAN Study Group 2017, 'Abdominal aortic calcification in patients with CKD' Journal of Nephrology, vol. 30, no. 1, pp. 109-118. https://doi.org/10.1007/s40620-015-0260-7

Abdominal aortic calcification in patients with CKD. / Peeters, Mieke J; van den Brand, Jan Ajg; van Zuilen, Arjan D; Koster, Yelka; Bots, Michiel L; Vervloet, Marc G; Blankestijn, Peter J; Wetzels, Jack Fm; MASTERPLAN Study Group.

In: Journal of Nephrology, Vol. 30, No. 1, 02.2017, p. 109-118.

Research output: Contribution to journalArticleProfessional

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AU - van den Brand, Jan Ajg

AU - van Zuilen, Arjan D

AU - Koster, Yelka

AU - Bots, Michiel L

AU - Vervloet, Marc G

AU - Blankestijn, Peter J

AU - Wetzels, Jack Fm

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N2 - BACKGROUND: Abdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients.METHODS: We included patients with CKD not receiving renal replacement therapy from the MASTERPLAN study, a randomized controlled trial that started in 2004. In the period 2008-2009, an X-ray to evaluate AAC was performed in a subgroup of patients. We studied AAC using a semi-quantitative scoring system by lateral lumbar X-ray. We used baseline and 2-year data to find determinants of AAC. We used a composite cardiovascular endpoint and propensity score matching to evaluate the prognostic value of AAC.RESULTS: In 280 patients an X-ray was performed. In 79 patients (28 %) the X-ray showed no calcification, in 62 patients (22 %) calcification was minor (<4), while 139 patients (50 %) had moderate or heavy calcification (≥4). Older age, prior cardiovascular disease, higher triglyceride levels, and higher phosphate levels were independent determinants of a calcification score ≥4. AAC score ≥4 was independently associated with cardiovascular events, with a hazard ratio of 5.5 (95 % confidence interval 1.2-24.8).CONCLUSIONS: Assessment of AAC can identify CKD patients at higher cardiovascular risk, and may provide important information for personalized treatment. Whether this approach will ultimately translate into better outcomes remains to be answered.

AB - BACKGROUND: Abdominal aortic calcification (AAC) is independently associated with cardiovascular events in dialysis patients and in the general population. However, data in non-dialysis chronic kidney disease (CKD) patients are limited. We analyzed determinants and prognostic value of AAC in non-dialysis CKD patients.METHODS: We included patients with CKD not receiving renal replacement therapy from the MASTERPLAN study, a randomized controlled trial that started in 2004. In the period 2008-2009, an X-ray to evaluate AAC was performed in a subgroup of patients. We studied AAC using a semi-quantitative scoring system by lateral lumbar X-ray. We used baseline and 2-year data to find determinants of AAC. We used a composite cardiovascular endpoint and propensity score matching to evaluate the prognostic value of AAC.RESULTS: In 280 patients an X-ray was performed. In 79 patients (28 %) the X-ray showed no calcification, in 62 patients (22 %) calcification was minor (<4), while 139 patients (50 %) had moderate or heavy calcification (≥4). Older age, prior cardiovascular disease, higher triglyceride levels, and higher phosphate levels were independent determinants of a calcification score ≥4. AAC score ≥4 was independently associated with cardiovascular events, with a hazard ratio of 5.5 (95 % confidence interval 1.2-24.8).CONCLUSIONS: Assessment of AAC can identify CKD patients at higher cardiovascular risk, and may provide important information for personalized treatment. Whether this approach will ultimately translate into better outcomes remains to be answered.

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DO - 10.1007/s40620-015-0260-7

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VL - 30

SP - 109

EP - 118

JO - Journal of Nephrology

JF - Journal of Nephrology

SN - 1121-8428

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Peeters MJ, van den Brand JA, van Zuilen AD, Koster Y, Bots ML, Vervloet MG et al. Abdominal aortic calcification in patients with CKD. Journal of Nephrology. 2017 Feb;30(1):109-118. https://doi.org/10.1007/s40620-015-0260-7