Abstract:
BACKGROUND:Despite the significant morbidity and mortality attributable to cardiovascular disease (CVD), risk stratification remains an important challenge in the chronic kidney disease (CKD) population. We examined the discriminative ability of noninvasive measures of atherosclerosis, including carotid intima-media thickness (cIMT), carotid plaque, coronary artery calcification (CAC) and ascending and descending thoracic aorta calcification (TCAC), and Framingham risk score (FRS) to predict self-reported prevalent CVD. METHODS AND RESULTS:Participants were enrolled in the cIMT ancillary study of the Chronic Renal Insufficiency Cohort (CRIC) study and also had all of the above measures within an 18-month period. CVD was present in 21% of study participants. C-statistics were used to ascertain the discriminatory power of each measure of atherosclerosis. The study population (n = 220) was 64% male; 51% black and 45% white. The proportion of individuals with estimated glomerular filtration rate ≥60, 45-59, 30-44, and <30 ml/min/1.73 m(2) was 21, 41, 28, and 11%, respectively. In multivariable analyses adjusting for demographic factors, we failed to find a difference between CAC, carotid plaque, and cIMT as predictors of self-reported prevalent CVD (C-statistic 0.70, 95% CI: 0.62-0.78; C-statistic 0.68, 95% CI: 0.60-0.75, and C-statistic 0.64, CI: 0.56-0.72, respectively). CAC was statistically better than FRS. FRS was the weakest discriminator of self-reported prevalent CVD (C-statistic 0.58). CONCLUSIONS:There was a significant burden of atherosclerosis among individuals with CKD, ascertained by several different imaging modalities. We were unable to find a difference in the ability of CAC, carotid plaque, and cIMT to predict self-reported prevalent CVD.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Adeseun GA,Xie D,Wang X,Joffe MM,Mohler ER 3rd,Townsend RR,Budoff M,Rosas SEdoi
10.1159/000342794subject
Has Abstractpub_date
2012-01-01 00:00:00pages
342-7issue
4eissn
0250-8095issn
1421-9670pii
000342794journal_volume
36pub_type
杂志文章abstract::Accelerated atherosclerosis is both a cause and a consequence of chronic renal failure. Vascular smooth muscle cells (VSMCs) are an important component of atherosclerotic plaques, responsible for promoting plaque stability in advanced lesions. In contrast, VSMC apoptosis has been implicated in a number of deleterious ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
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abstract::Acute hyperammonemia is an emergent cause of central nervous system dysfunction for which renal replacement therapy is advocated. We report the successful use of continuous venovenous hemodiafiltration in this metabolic emergency, and report the calculated ammonia clearances for both continuous venovenous hemofiltrati...
journal_title:American journal of nephrology
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journal_title:American journal of nephrology
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pub_type: 杂志文章,meta分析,评审
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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journal_title:American journal of nephrology
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更新日期:2016-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,评审
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更新日期:1990-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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更新日期:2009-01-01 00:00:00
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journal_title:American journal of nephrology
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journal_title:American journal of nephrology
pub_type: 杂志文章,评审
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:1995-01-01 00:00:00
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journal_title:American journal of nephrology
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更新日期:1987-01-01 00:00:00