Association of cardiac valvular calcifications and C-reactive protein with cardiovascular mortality in incident hemodialysis patients: a Japanese cohort study.
Am J Kidney Dis
; 61(2): 254-61, 2013 Feb.
Article
em En
| MEDLINE
| ID: mdl-23122492
ABSTRACT
BACKGROUND:
Cardiac valve calcification is seen frequently in patients undergoing dialysis. Serum C-reactive protein (CRP) level also is reported to predict future cardiovascular events. We investigated the association among valve calcification, CRP level, and mortality in patients with end-stage renal disease who were just beginning hemodialysis (HD) therapy. STUDYDESIGN:
Observational cohort. SETTING &PARTICIPANTS:
1,290 consecutive patients who just started HD therapy were enrolled and were followed up to 10 years. PREDICTOR Patients were divided into 3 groups according to number of calcified valves those without valve calcification, those with calcification in a single (aortic or mitral) valve, and those with calcification in both valves. They also were divided into tertiles according to CRP level.OUTCOMES:
Cardiovascular and all-cause mortality. MEASUREMENTS Echocardiography and CRP measurement were performed within 1 month after beginning HD therapy.RESULTS:
During follow-up (median, 51 months), 335 (25.9%) patients died, including 156 (12.1%) of cardiovascular disease. The adjusted HR for cardiovascular mortality was 2.80 (95% CI, 1.63-4.81) for 2 calcifications versus 0 (P < 0.001). Furthermore, the risk of cardiovascular mortality was 3.66-fold higher in patients with calcifications in both valves (highest tertile of CRP) compared with patients without valve calcification (lowest tertile of CRP; P < 0.001).LIMITATIONS:
Precise medical treatments or therapeutic interventions were not evaluated.CONCLUSIONS:
Valve calcification and elevated CRP levels were not only related to additively increased risk of mortality, but also improved the prediction of mortality in patients with end-stage renal disease who had just begun HD therapy.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Calcinose
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Proteína C-Reativa
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Doenças Cardiovasculares
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Diálise Renal
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Doenças das Valvas Cardíacas
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Falência Renal Crônica
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article