Progression of Medial Arterial Calcification in CKD.
Progression of Medial Arterial Calcification in CKD.
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DOI：
10.1016/j.ekir.2018.07.011
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发表时间：
2018-11
影响因子：
6
通讯作者：
O'Neill WC
中科院分区：
文献类型：
--
作者：
Manzoor S;Ahmed S;Ali A;Han KH;Sechopoulos I;O'Neill A;Fei B;O'Neill WC
内侧动脉钙化在慢性肾脏病(CKD)中很常见，预示着不良的临床结果，但由于缺乏可靠的量化，其进展与CKD的严重程度和其他危险因素的作用尚不清楚。乳房X光摄影检测到的乳腺动脉钙化是唯一的内侧钙化，它与外周动脉的内侧钙化和心血管预后相关，用于测量患有慢性肾脏病和终末期肾病(ESRD)的女性的内侧动脉钙化的进展。测量显示，观察者内和观察者间的相关性为0.98，研究间变异性为8%至11%，与计算机断层扫描测量的相关性为0.92。对60名对照组(估计肾小球滤过率为每1.73m2 90ml/分钟)和137名慢性肾脏病患者(每1.73m2估计肾小球滤过率为90ml/分钟)的钙化进程进行了测量。对照组受试者的进展率随时间呈线性变化，且与年龄无关。慢性肾脏病的进展率增加，但仅当EGFR为40ml/分钟/1.73m2时(中位数为8.1mlvs.3.9 mm/乳房/年；P=0.006)。终末期肾病患者的进展明显加快(中位数，20 mm/乳房/年；n=36)，但与肾移植后的对照组(n=25)无差异。糖尿病显著增加了CKD和ESRD患者的病情进展，但在对照组中并非如此。钼靶摄影是测量内侧动脉钙化进展的一种方便可靠的方法。进展不会增加，直到CKD的晚期，在终末期肾病明显加速，并在肾移植后恢复到控制率。糖尿病显著增加慢性肾脏病和终末期肾病的进展。
Medial arterial calcification is common in chronic kidney disease (CKD) and portends poor clinical outcomes, but its progression relative to the severity of CKD and the role of other risk factors is unknown because of the lack of reliable quantification. Calcification of breast arteries detected by mammography, which is exclusively medial and correlates with medial calcification in peripheral arteries and with cardiovascular outcomes, was used to measure the progression of medial arterial calcification in women with CKD and end-stage renal disease (ESRD). Measurements showed intra- and interobserver correlations of 0.98, an interstudy variability of 8% to 11%, and a correlation with computed tomographic measurements of 0.92. Progression of calcification was measured in 60 control subjects (estimated glomerular filtration rate (eGFR) ≥ 90 ml/min per 1.73 m2) and 137 subjects with CKD (eGFR < 90 ml/min per 1.73 m2). Progression in control subjects was linear over time and independent of age. The rate of progression was increased in CKD but only at eGFR < 40 ml/min per 1.73 m2 (median, 8.1 vs. 3.9 mm/breast/yr in controls; P = 0.006). Progression accelerated markedly in subjects with ESRD (median, 20 mm/breast/yr; n = 36), but did not differ from controls after kidney transplantation (n = 25). Diabetes significantly augmented progression in subjects with CKD and ESRD but not in controls. Mammography is a convenient and reliable method to measure the progression of medial arterial calcification. Progression does not increase until advanced stages of CKD, accelerates markedly in ESRD, and returns to control rates after kidney transplantation. Diabetes significantly increases progression in CKD and ESRD.
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影响因子：
2.8
作者：
Crystal, P;Crystal, E;Strano, S
通讯作者：
Strano, S
DOI：
10.2215/cjn.06490711
发表时间：
2012-02-01
影响因子：
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发表时间：
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作者：
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影响因子：
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作者：
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作者：
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