Biomarkers of bone and mineral disorders (Fgf-23, fetuin-a) and vascular calcification scores as predictive tools for cardiovascular death in dialysis patients, at 10 years of follow-up[Biomarcadores del metabolismo mineral óseo (Fgf-23, fetuína-a) y calcificaciones vascu-lares como herramientas predictivas de muerte cardiovascular de pacientes en diálisis, a 10 años de seguimiento.]
Cardiovascular disorders represent the leading cause of death in dialysis patients. Alterations of bone and mineral metabolism (BMM) and vascular calcifications play a fundamental role in it. The objective of this study was to evaluate the predictive role on cardiovascular mortality of the measureme...
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| Autores principales: | , , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | Español |
| Publicado: |
Instituto de Investigaciones Medicas
2021
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| Materias: | |
| Acceso en línea: | http://pa.bibdigital.ucc.edu.ar/3327/1/A_Fernandez_Douthat_Castellano.pdf |
| Aporte de: |
| Sumario: | Cardiovascular disorders represent the leading cause of death in dialysis patients. Alterations of bone and mineral metabolism (BMM) and vascular calcifications play a fundamental role in it. The objective of this study was to evaluate the predictive role on cardiovascular mortality of the measurement of biomarkers of BMM and vascular calcifications. A prospective cohort study was performed. All prevalent patients on chronic dialysis in September 2009 at our institution, who completed the total of the complementary stud-ies, were studied. BMM biomarkers were measured (FGF 23, fetuin A, PTH, calcium and phosphorus) and the vascular calcifications were evaluated using the Kauppila and Adragao scores. Follow-up was carried out until 1/1/2019, death or transplant. Of the 30 patients included, 7 (23.3%) died due to cardiovascular causes. The follow-up time was 44.1 ± 30.4 (range = 1.4-112) months. The Adragao score was the only predictive variable of long-term cardiovascular mortality (area under the curve = 0.82; 95% CI 0.64-0.94; p < 0.001). The best cut-off point was 5 (sensitivity = 85.7%; specificity = 78.3%). It was also an independent risk factor for cardiovascular mortality adjusted for age, diabetes mellitus, coronary heart disease, aortic calcifications, time spent on dialysis and follow-up time (adjusted OR = 1.77; 95% CI = 1.06-2.96; p = 0.028). The vascular calcifications quantified from the Adragao score were the only independent predictor of long-term cardiovascular mortality. This score represents a simple, useful and superior tool to the biomarkers of BMM. |
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