Original investigationsPathogenesis and treatment of kidney disease and hypertensionCoronary artery calcification in patients with CRF not undergoing dialysis
Section snippets
Methods
The protocol was approved by the local institutional review board.
Consecutive outpatients with a glomerular filtration rate (GFR) unchanged for at least 12 months before study entry were enrolled after they had given informed consent. Exclusion criteria were symptoms of heart failure or coronary artery disease; previous history of myocardial infarction, coronary bypass surgery, or angioplasty; and stroke, diabetes, rapidly progressive renal disease, or arrhythmia (that would exclude gating
Results
One hundred forty individuals were studied: 85 patients with CRF and 55 controls.
Clinical characteristics and biochemical variables are listed in Table 1. Patients and controls were well matched for clinical characteristics and biochemical variables, including values for serum calcium, phosphorus, and calcium-phosphorus product. Variables strictly linked to renal function, such as urea level, GFR, iPTH level, and homocysteine level, were significantly different in controls. Causes of renal
Discussion
CAC is common not only in patients who have been on dialysis therapy for years, but also in those who initiate dialysis treatment.2, 3, 4, 5, 15, 16 Recently, CAC was evaluated in patients with CRF not yet on dialysis therapy, but with documented coronary artery disease.17 The study focused on the effects of some antihypertensive drugs (ie, calcium channel blockers versus diuretics) on plaque progression, rather than on prevalence of CAC. To date, no data are available on the prevalence of CAC
References (21)
- et al.
Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients
Am J Kidney Dis
(1996) - et al.
Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease?
J Am Coll Cardiol
(2002) - et al.
Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients
Kidney Int
(2002) - et al.
Medial artery calcification in ESRD patients is associated with deposition of bone matrix proteins
Kidney Int
(2002) - et al.
Quantification of coronary artery calcium using ultrafast computed tomography
J Am Coll Cardiol
(1990) - et al.
Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysisA cross-sectional study
Lancet
(2003) - et al.
Inflammation enhances cardiovascular risk and mortality in hemodialysis patients
Kidney Int
(1999) - et al.
Hyperhomocysteinemia and the prevalence of atherosclerotic vascular disease in patients with end-stage renal disease
Am J Kidney Dis
(1999) Cardiovascular complications in chronic kidney disease
Am J Kidney Dis
(2003)- et al.
Angiographic progression of coronary artery disease in patients with end stage renal disease
Nephrol Dial Transplant
(2001)