Progression of Aortic Arch Calcification Over 1 Year Is an Independent Predictor of Mortality in Incident Peritoneal Dialysis Patients 英文参考文献.docVIP

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Progression of Aortic Arch Calcification Over 1 Year Is an Independent Predictor of Mortality in Incident Peritoneal Dialysis Patients 英文参考文献.doc

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Progression of Aortic Arch Calcification Over 1 Year Is an Independent Predictor of Mortality in Incident Peritoneal Dialysis Patients 英文参考文献

ProgressionofAorticArchCalcificationOver1YearIsan IndependentPredictorofMortalityinIncidentPeritoneal DialysisPatients MiJungLee1,DongHoShin1,SeungJunKim1,HyungJungOh1,DongEunYoo1,KwangIlKo1 ,Hyang MoKoo1,ChanHoKim1,FaMeeDoh1,JungTakPark1,SeungHyeokHan1,Tae-HyunYoo1,2 ,Kyu HunChoi1,Shin-WookKang1,2* 1DepartmentofInternalMedicine,CollegeofMedicine,YonseiUniversity,Seoul,Korea,2SeveranceBiomedicalScienceInstitute,BrainKorea21,YonseiUniversity,Seoul, Korea Abstract BackgroundsandAims:Thepresenceandprogressionofvascularcalcificationhavebeendemonstratedasimportantrisk factors for mortality in dialysis patients. However, since the majority of subjects included in most previous studies were hemodialysispatients,limitedinformationwasavailableinperitonealdialysis(PD)patients.Therefore,theaimofthisstudy was to investigate the prevalence of aortic arch calcification (AoAC) and prognostic value of AoAC progression in PD patients. Methods:WeprospectivelydeterminedAoACbychestX-rayatPDstartandafter12months,andevaluatedtheimpactof AoACprogressiononmortalityin415incidentPDpatients. Results:Of415patients,169patients(40.7%)hadAoACatbaselinewithameanof18.1611.2%.Thepresenceofbaseline AoAC was an independent predictor of all-cause [Hazard ratio (HR): 2.181, 95% confidence interval (CI): 1.336–3.561, P=0.002]andcardiovascularmortality(HR:3.582,95%CI:1.577–8.132,P=0.002).Among363patientswithfollow-upchest X-raysat12monthsafterPDstart,theproportionofpatientswithAoACprogressionwassignificantlyhigherinpatients withbaselineAoAC(64.2vs.5.3%,P,0.001).Moreover,all-causeandcardiovasculardeathratesweresignificantlyhigherin the progression groups than in the non-progression group (P,0.001). Multivariate Cox analysis revealed that AoAC progression was an independent predictor for all-cause (HR: 2.625, 95% CI: 1.150–5.991, P=0.022) and cardiovascular mortality(HR:4.008,95%CI:1.079–14.890,P=0.038)inpatientswithAoACatbaseline. Conclusions: The presence and progression of AoAC assessed by chest X-ray