%0 Journal Article
%T Carotid artery calcification at the initiation of hemodialysis is a risk factor for cardiovascular events in patients with end-stage renal disease: a cohort study
%A Masaru Nakayama
%A Yoriko Ura
%A Masaharu Nagata
%A Yasushi Okada
%A Yoko Sumida
%A Kanako Nishida
%A Hirofumi Ikeda
%A Yoshiki Kaizu
%J BMC Nephrology
%D 2011
%I BioMed Central
%R 10.1186/1471-2369-12-56
%X One-hundred thirty-three patients who had been started on hemodialysis between 2004 and 2008 were included in this retrospective cohort study. These patients received multi-detector computed tomography to assess CAAC at the initiation of hemodialysis. Composite CV events, including ischemic heart disease, heart failure, cerebrovascular diseases, and CV deaths after the initiation of hemodialysis, were examined in each patient.CAAC was found in 94 patients (71%). At the end of follow-up, composite CV events were seen in 47 patients: ischemic heart disease in 20, heart failure in 8, cerebrovascular disease in 12, and CV deaths in 7. The incidence of CAAC was 87% in patients with CV events, which was significantly higher than the rate (62%) in those without. Kaplan-Meier analysis showed a significant increase in composite CV events in patients with CAAC compared with those without CAAC (p = 0.001, log-rank test). Univariate analysis using a Cox hazards model showed that age, smoking, common carotid artery intima-media thickness and CAAC were risk factors for composite CV events. In multivariate analysis, only CAAC was a significant risk factor for composite CV events (hazard ratio, 2.85; 95% confidence interval, 1.18-8.00; p = 0.02).CAAC is an independent risk factor for CV events in ESRD patients. The assessment of CAAC at the initiation of hemodialysis is useful for predicting the prognosis.The annual mortality rate due to cardiovascular (CV) disease in patients with end-stage renal disease (ESRD) is more than an order of magnitude greater than that in the population with normal kidney function [1]. Vascular calcification is a common complication of ESRD. Arterial disease in patients with ESRD is characterized by a high degree of intimal as well as medial calcification. Arterial intimal calcification is associated with atherosclerotic burden, resulting in arterial stenosis or occlusion; on the other hand, arterial medial calcification is related to arteriosclerosis,
%U http://www.biomedcentral.com/1471-2369/12/56