Progression of Vascular Calcification and Clinical Outcomes in Patients Receiving Maintenance Dialysis

作者：Hai‐Tao Zhang, Guisen Li, Xueqing Yu, Junwei Yang, Aili Jiang, Hong Cheng, Junzhou Fu, Xinling Liang, Jun Liu, Jizhuang Lou, Mei Wang, Changying Xing, Aihua Zhang, Miao Zhang, Xiangcheng Xiao, Yu Chen, Rong Wang, Li Wang, Yuqing Chen, Tianjun Guan, Ai Peng, Nan Chen, Chuan‐Ming Hao, Bi‐Cheng Liu, Suxia Wang, Dan Shen, Zhenhua Jia, Zhihong Liu, China Dialysis Calcification Study Group, Chunxia Zheng, Peiling Chen, Xiao Yang, Xunhuan Zheng, Xueqin Bian, Hong Ye, Lan Jia, Haibo Yu, Guoqin Wang, Xiaoyi Xu, Lin Chen, Lixia Xu, Zhilian Li, Guohua Zhang, Hongbo Yuan, Liangying Gan, Huiping Zhao, Yifei Ge, Li Li, Wenling Yang, He Lian, Cheng Sun, Qiongjing Yuan, Aihong Yuan, Bing Liu, Yang Zou, Xuyang Cheng, Qing Gao, Yaxiang Song, Da Shang, Bin Wang, Fengyu Jia · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.10909 · 被引用次数：125 · 研究领域：Parathyroid Disorders and Treatments、Dialysis and Renal Disease Management、Cardiac Imaging and Diagnostics

Importance: Baseline findings from the China Dialysis Calcification Study (CDCS) revealed a high prevalence of vascular calcification (VC) among patients with end-stage kidney disease; however, data on VC progression were limited. Objectives: To understand the progression of VC at different anatomical sites, identify risk factors for VC progression, and assess the association of VC progression with the risk of cardiovascular events and death among patients receiving maintenance dialysis. Design, Setting, and Participants: This cohort study was a 4-year follow-up assessment of participants in the CDCS, a nationwide multicenter prospective cohort study involving patients aged 18 to 74 years who were undergoing hemodialysis or peritoneal dialysis. Participants were recruited from 24 centers across China between May 1, 2014, and April 30, 2015, and followed up for 4 years. A total of 1489 patients receiving maintenance dialysis were included in the current analysis. Data were analyzed from September 1 to December 31, 2021. Exposures: Patient demographic characteristics and medical history; high-sensitivity C-reactive protein laboratory values; serum calcium, phosphorus, and intact parathyroid hormone (iPTH) values; and previous or concomitant use of medications. Main Outcomes and Measures: The primary outcome was progression of VC at 3 different anatomical sites (coronary artery, abdominal aorta, and cardiac valves) and identification of risk factors for VC progression. Participa...