Department of Advanced Medicine for Uremia, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan.
J Ren Nutr. 2012 Jan;22(1):139-42. doi: 10.1053/j.jrn.2011.10.024.
Coronary artery calcification has been associated with higher mortality in coronary artery disease and chronic kidney disease. This study aimed to correlate coronary artery calcification score (CACS) with all-cause and cardiovascular mortalities in hemodialysis (HD) patients.
DESIGN, SETTING, SUBJECTS: A survival analysis was conducted in 200 HD patients. CACS was assessed by multidetector-row computed tomography and stratified as tertiles: group 1 (0∼105 U), group 2 (110∼1067 U), and group 3 (1094∼15481 U). The duration of follow-up was 7 years and 4 months. Kaplan-Meier method and Cox proportional hazard analysis adjusted for age and HD duration were performed to examine the impact of CACS on survival.
All-cause and cardiovascular mortalities were measured.
The cumulative all-cause and cardiovascular mortalities of group 1 were significantly lower than those of groups 2 and 3 (all-cause mortality: 7.6% vs. 43.3% and 52.2%, respectively, cardiovascular mortality: 3.0% vs. 22.4% and 26.9%, respectively). Cox proportional hazard analysis adjusted for age and HD duration revealed that all-cause and cardiovascular mortalities of group 1 were significantly lower than those of groups 2 and 3.
CACS is helpful to predict prognosis of HD patients independently of age and HD duration.
冠状动脉钙化与冠心病和慢性肾脏病的死亡率升高有关。本研究旨在探讨冠状动脉钙化评分（CACS）与血液透析（HD）患者全因和心血管死亡率的相关性。
设计、地点、研究对象：对 200 名 HD 患者进行生存分析。采用多排螺旋 CT 评估 CACS，并分为三分位：第 1 组（0∼105 U）、第 2 组（110∼1067 U）和第 3 组（1094∼15481 U）。随访时间为 7 年 4 个月。采用 Kaplan-Meier 法和 Cox 比例风险分析，调整年龄和 HD 持续时间，观察 CACS 对生存率的影响。
全因和心血管死亡率。
第 1 组的累积全因和心血管死亡率明显低于第 2 组和第 3 组（全因死亡率：7.6%比 43.3%和 52.2%，心血管死亡率：3.0%比 22.4%和 26.9%）。经年龄和 HD 持续时间校正的 Cox 比例风险分析显示，第 1 组的全因和心血管死亡率明显低于第 2 组和第 3 组。
CACS 有助于独立于年龄和 HD 持续时间预测 HD 患者的预后。
