Association of aortic valve calcification with carotid artery lesions and peripheral artery disease in patients with chronic kidney disease: a cross-sectional study.
Adult
Aged
Aged, 80 and over
Ankle Brachial Index
Aortic Valve
/ diagnostic imaging
Aortic Valve Stenosis
/ diagnostic imaging
Calcinosis
/ diagnostic imaging
Calcium
/ blood
Carotid Artery Diseases
/ diagnostic imaging
Cross-Sectional Studies
Echocardiography
Female
Fibroblast Growth Factor-23
Fibroblast Growth Factors
/ blood
Humans
Lansoprazole
Male
Middle Aged
Parathyroid Hormone
/ blood
Peripheral Arterial Disease
/ epidemiology
Phosphorus
/ blood
Renal Insufficiency, Chronic
/ epidemiology
Vitamin D
/ analogs & derivatives
Young Adult
Aortic valve calcification
Atherosclerosis
Carotid artery plaque
Chronic kidney disease
Peripheral artery disease
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
29 05 2020
29 05 2020
Historique:
received:
19
12
2019
accepted:
21
05
2020
entrez:
31
5
2020
pubmed:
31
5
2020
medline:
2
9
2021
Statut:
epublish
Résumé
Patients with chronic kidney disease (CKD) reportedly have a high prevalence of aortic valve calcification (AVC). In population-based studies, AVC is considered a manifestation of systemic atherosclerosis. The association of AVC with atherosclerotic lesions has not been fully investigated in predialysis patients. The present study was performed to determine whether carotid artery lesions and peripheral artery disease (PAD) are associated with AVC in patients with CKD not on dialysis. In total, 749 patients were included in this cross-sectional study. AVC was evaluated using echocardiography. Carotid artery lesions including carotid artery plaque (CAP) and PAD were simultaneously examined in each patient. A logistic regression analysis was applied to determine the factors associated with AVC. AVC, CAP, and PAD were found in 201, 583, and 123 patients, respectively. In the multivariable analyses adjusted for covariates including the estimated glomerular filtration rate and makers of mineral metabolism (serum calcium, serum phosphorus, parathyroid hormone, 1,25-dihydroxyvitamin D, and fibroblast growth factor 23), AVC was significantly associated with the presence of CAP [odds ratio (OR), 3.37; 95% confidence interval (CI), 1.43-7.95], the presence of PAD (OR, 1.76; 95% CI, 1.10-2.81), the CAP score (per 1.0-point increase) (OR, 1.06; 95% CI, 1.02-1.11), and the ankle-brachial blood pressure index (per 0.1-point increase) (OR, 0.83; 95% CI, 0.72-0.95). AVC was associated with atherosclerotic lesions independent of kidney function and mineral metabolism. We consider that this association between AVC and atherosclerosis might reflect the burden of shared atherosclerotic risk factors.
Sections du résumé
BACKGROUND
Patients with chronic kidney disease (CKD) reportedly have a high prevalence of aortic valve calcification (AVC). In population-based studies, AVC is considered a manifestation of systemic atherosclerosis. The association of AVC with atherosclerotic lesions has not been fully investigated in predialysis patients. The present study was performed to determine whether carotid artery lesions and peripheral artery disease (PAD) are associated with AVC in patients with CKD not on dialysis.
METHODS
In total, 749 patients were included in this cross-sectional study. AVC was evaluated using echocardiography. Carotid artery lesions including carotid artery plaque (CAP) and PAD were simultaneously examined in each patient. A logistic regression analysis was applied to determine the factors associated with AVC.
RESULTS
AVC, CAP, and PAD were found in 201, 583, and 123 patients, respectively. In the multivariable analyses adjusted for covariates including the estimated glomerular filtration rate and makers of mineral metabolism (serum calcium, serum phosphorus, parathyroid hormone, 1,25-dihydroxyvitamin D, and fibroblast growth factor 23), AVC was significantly associated with the presence of CAP [odds ratio (OR), 3.37; 95% confidence interval (CI), 1.43-7.95], the presence of PAD (OR, 1.76; 95% CI, 1.10-2.81), the CAP score (per 1.0-point increase) (OR, 1.06; 95% CI, 1.02-1.11), and the ankle-brachial blood pressure index (per 0.1-point increase) (OR, 0.83; 95% CI, 0.72-0.95).
CONCLUSIONS
AVC was associated with atherosclerotic lesions independent of kidney function and mineral metabolism. We consider that this association between AVC and atherosclerosis might reflect the burden of shared atherosclerotic risk factors.
Identifiants
pubmed: 32471374
doi: 10.1186/s12882-020-01864-z
pii: 10.1186/s12882-020-01864-z
pmc: PMC7260754
doi:
Substances chimiques
Parathyroid Hormone
0
Lansoprazole
0K5C5T2QPG
Vitamin D
1406-16-2
Phosphorus
27YLU75U4W
Fibroblast Growth Factors
62031-54-3
1,25-dihydroxyvitamin D
66772-14-3
Fibroblast Growth Factor-23
7Q7P4S7RRE
Calcium
SY7Q814VUP
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
203Références
Am J Cardiol. 2010 Dec 15;106(12):1787-91
pubmed: 21055710
J Am Soc Nephrol. 2009 Feb;20(2):381-7
pubmed: 19073826
Lancet. 1987 Oct 17;2(8564):875-7
pubmed: 2889080
Atherosclerosis. 2014 Apr;233(2):331-337
pubmed: 24530958
Circulation. 2004 Jul 20;110(3):356-62
pubmed: 15249504
Am J Cardiol. 2009 May 15;103(10):1473-7
pubmed: 19427449
J Atheroscler Thromb. 2018 Jan 1;25(1):55-64
pubmed: 28179606
Nephrol Dial Transplant. 2013 Dec;28(12):2968-76
pubmed: 24097800
Am J Kidney Dis. 2009 Jun;53(6):982-92
pubmed: 19339088
Clin Kidney J. 2015 Dec;8(6):732-6
pubmed: 26613033
Hypertens Res. 2014 Mar;37(3):246-52
pubmed: 24089265
Clin J Am Soc Nephrol. 2011 Aug;6(8):1990-5
pubmed: 21700824
Am J Cardiol. 2018 Nov 15;122(10):1732-1737
pubmed: 30270179
Indian Heart J. 2015 Sep-Oct;67(5):503-6
pubmed: 26432749
Kidney Int. 2011 Sep;80(6):572-86
pubmed: 21750584
J Am Heart Assoc. 2017 Oct 11;6(10):
pubmed: 29021274
J Heart Valve Dis. 2009 Jul;18(4):429-38
pubmed: 19852148
J Am Soc Nephrol. 2006 Feb;17(2):521-7
pubmed: 16382018
Clin Nephrol. 2010 May;73(5):360-9
pubmed: 20420796
Am J Kidney Dis. 2007 Sep;50(3):412-20
pubmed: 17720520
JACC Cardiovasc Imaging. 2012 Jun;5(6):619-25
pubmed: 22698532
Hypertens Res. 2014 Dec;37(12):1050-5
pubmed: 25056682
N Engl J Med. 2004 Sep 23;351(13):1296-305
pubmed: 15385656
Arterioscler Thromb Vasc Biol. 2017 Apr;37(4):623-632
pubmed: 28153876
J Am Coll Cardiol. 2014 Sep 23;64(12):1202-13
pubmed: 25236511
J Am Coll Cardiol. 1997 Mar 1;29(3):630-4
pubmed: 9060903
Clin Nutr. 2014 Jun;33(3):443-7
pubmed: 23920500
Atherosclerosis. 2018 Jun;273:145-152
pubmed: 29655832
Clin Exp Nephrol. 2015 Dec;19(6):1090-7
pubmed: 25757535
Circulation. 2005 Jun 21;111(24):3316-26
pubmed: 15967862
Nephrol Dial Transplant. 1998 Aug;13(8):2037-40
pubmed: 9719161
Hypertens Res. 2010 Jun;33(6):622-6
pubmed: 20379193
Arch Intern Med. 2005 Feb 14;165(3):327-32
pubmed: 15710797
Heart. 2017 Oct;103(20):1619-1624
pubmed: 28698175
Circ J. 2017 Feb 24;81(3):281-289
pubmed: 28123169
Heart. 1997 Nov;78(5):472-4
pubmed: 9415006
J Am Heart Assoc. 2016 Feb 22;5(2):
pubmed: 26903006
Am J Cardiol. 2015 May 1;115(9):1281-6
pubmed: 25791240
Am J Cardiol. 2004 Dec 1;94(11):1396-402, A6
pubmed: 15566910
Circulation. 2003 Oct 28;108(17):2154-69
pubmed: 14581387
Am J Kidney Dis. 2013 Feb;61(2):254-61
pubmed: 23122492