Mizuiri Sonoo, Nishizawa Yoshiko, Yamashita Kazuomi, Mizuno Kenji, Ishine Masahiro, Doi Shigehiro, Masaki Takao, Shigemoto Kenichiro
Department of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan.
Department of Radiology, Ichiyokai Harada Hospital, Hiroshima, Japan.
Nephrology (Carlton). 2018 Sep;23(9):837-845. doi: 10.1111/nep.13113. Epub 2018 Feb 20.
Many studies have validated Agatston's coronary artery calcification score (CACS) for assessing vascular calcification (VC) in chronic kidney disease (CKD) patients. This study aimed to evaluate the CACS and common iliac artery calcification score (IACS) and to examine the variables related to each score.
The subjects were 145 non-dialysis CKD patients. The CACS and IACS were determined using the same thoracicoabdominal multi-detector computed tomography. Multiple regression analyses were performed to assess the factors associated with the CACS or IACS. The associations between progression to renal replacement therapy (RRT) and the CACS or IACS were studied using Cox hazards models.
The subjects' median age, estimated glomerular filtration rate (eGFR), and follow-up period were 72 (62-78) years, 32 (18-50) mL/min/1.73m , and 864 (550-1425) days, respectively. Age, diabetes, the serum phosphate level, and the eGFR were found to be significant factors of the CACS [β (95% CI): 0.38 (0.02-0.04), P < 0.0001, 0.28 (0.19-0.50), P < 0.0001, 0.16 (0.03-0.45), P < 0.05 and -0.15 (-0.02-0.00), P < 0.05, respectively]. Age and diabetes were shown to be significant factors of the IACS [β (95% CI): 0.53 (0.04-0.06), P < 0.0001, and 0.18 (0.07-0.40), P < 0.01, respectively]. Progression to RRT occurred in 31 patients and was significantly associated with the CACS (hazard ratio: 1.01, P < 0.01), urinary protein level and eGFR, but not the IACS.
Chronic kidney disease related risk factors for VC, such as the eGFR and hyperphosphataemia, are significantly associated with a high CACS, but not a high IACS, and the CACS is a significant predictor of progression to RRT.
许多研究已验证阿加斯顿冠状动脉钙化评分（CACS）可用于评估慢性肾脏病（CKD）患者的血管钙化（VC）情况。本研究旨在评估CACS和髂总动脉钙化评分（IACS），并研究与各评分相关的变量。
研究对象为145例非透析CKD患者。使用相同的胸腹多排螺旋计算机断层扫描确定CACS和IACS。进行多元回归分析以评估与CACS或IACS相关的因素。使用Cox风险模型研究进展至肾脏替代治疗（RRT）与CACS或IACS之间的关联。
研究对象的中位年龄、估计肾小球滤过率（eGFR）和随访时间分别为72（62 - 78）岁、32（18 - 50）mL/min/1.73m²和864（550 - 1425）天。年龄、糖尿病、血清磷酸盐水平和eGFR被发现是CACS的显著影响因素[β（95%CI）：0.38（0.02 - 0.04），P < 0.0001；0.28（0.19 - 0.50），P < 0.0001；0.16（0.03 - 0.45），P < 0.05；-0.15（-0.02 - 0.00），P < 0.05]。年龄和糖尿病被证明是IACS的显著影响因素[β（95%CI）：0.53（0.04 - 0.06），P < 0.0001；0.18（0.07 - 0.40），P < 0.01]。31例患者进展至RRT，且与CACS（风险比：1.01，P < 0.01）、尿蛋白水平和eGFR显著相关，但与IACS无关。
CKD相关的VC危险因素，如eGFR和高磷血症，与高CACS显著相关，但与高IACS无关，且CACS是进展至RRT的显著预测指标。
