Introduction
Methods
Design and patient selection
Assessment of AAC
Cardiovascular outcome
Statistical analyses
Results
Assessment and severity of AAC
Determinants of AAC
Characteristic | Calcification score | p | |
---|---|---|---|
<4 (n = 141) | ≥4 (n = 139) | ||
Randomized to intervention group | 61 % | 56 % | 0.41 |
Age (years) | 55.2 (12.9) | 65.9 (8.3) | <0.001 |
Male gender | 67 % | 70 % | 0.66 |
Caucasian race | 89 % | 90 % | 0.88 |
Renovascular cause of kidney disease | 28 % | 35 % | 0.22 |
History of diabetes mellitusa
| 20 % | 33 % | 0.01 |
Prior cardiovascular diseaseb
| 18 % | 42 % | <0.001 |
eGFRc (ml/min/1.73 m2) | 36.6 (12.0) | 36.3 (13.3) | 0.81 |
Systolic blood pressure (mmHg) | 132 (15) | 138 (18) | 0.004 |
Diastolic blood pressure (mmHg) | 80 (10) | 78 (10) | 0.12 |
Ankle brachial indexd
| 1.12 (0.17) | 1.07 (0.20) | 0.01 |
Protein creatinine ratio (mg/10 mmol) | 123 [27–472] | 121 [18–646] | 0.17 |
Total cholesterol (mmol/l) | 4.64 (0.85) | 4.63 (0.82) | 0.92 |
LDL cholesterol (mmol/l) | 2.61 (0.81) | 2.56 (0.70) | 0.56 |
HDL cholesterol (mmol/l) | 1.39 (0.42) | 1.31 (0.39) | 0.10 |
Triglycerides (mmol/l) | 1.56 (0.83) | 1.81 (0.98) | 0.03 |
Calcium (mmol/l) | 2.36 (0.11) | 2.36 (0.12) | 0.74 |
Phosphate (mmol/l) | 1.07 (0.19) | 1.14 (0.20) | 0.003 |
PTH (pmol/l) | 7.5 [5.6–11.8] | 8.3 [5.5–12.0] | 0.66 |
FGF23 (RU/ml) | 99 [63–161] | 134 [70–191] | 0.14 |
Hemoglobin (mmol/l) | 8.4 (0.9) | 8.3 (0.8) | 0.55 |
Serum albumin (g/l) | 40.5 (3.4) | 39.7 (3.1) | 0.04 |
HbA1c (%) | 5.9 (0.8) | 6.2 (0.7) | <0.001 |
BMI (kg/m2) | 26.2 (4.8) | 27.1 (3.8) | 0.09 |
Smoking | 22 % | 21 % | 0.85 |
Urinary sodium creatinine ratio (mmol/mmol) | 13.9 (4.6) | 14.1 (4.8) | 0.72 |
Physical activity guideline adherence | 79 % | 78 % | 0.82 |
Aspirin use | 57 % | 64 % | 0.22 |
Oral anticoagulant drug use | 11 % | 15 % | 0.33 |
Statin use | 87 % | 95 % | 0.02 |
Vitamin D use | 41 % | 42 % | 0.87 |
Antihypertensive drug use | 93 % | 99 % | 0.04 |
Calcium containing phosphate binder use | 12 % | 10 % | 0.50 |
Sevelamer use | 6 % | 6 % | 0.95 |
Erythropoiesis stimulating agent use | 16 % | 15 % | 0.90 |
Characteristic | OR | 95 % CI | p |
---|---|---|---|
Age/10 (years) | 2.53 | 1.88–3.41 | <0.001 |
Prior cardiovascular diseasea
| 2.42 | 1.30–4.50 | 0.01 |
Triglycerides/0.1 (mmol/l) | 1.04 | 1.01–1.08 | 0.01 |
Phosphate/0.1 (mmol/l) | 1.29 | 1.10–1.50 | 0.001 |
Cardiovascular outcome
Characteristic | HR | 95 % CI | p |
---|---|---|---|
Calcification score ≥4 | 3.86 | 1.55–9.62 | 0.004 |
Randomized to intervention group | 0.53 | 0.24–1.14 | 0.11 |
Age/10 (years) | 2.11 | 1.36–3.28 | 0.001 |
Male gender | 1.05 | 0.46–2.41 | 0.92 |
Caucasian race | 1.38 | 0.33–5.84 | 0.66 |
Renovascular cause of kidney disease | 2.53 | 1.17–5.47 | 0.02 |
History of diabetes mellitusa
| 1.04 | 0.44–2.48 | 0.93 |
Prior cardiovascular diseaseb
| 1.50 | 0.68–3.32 | 0.31 |
eGFRc/5 (ml/min/1.73 m2) | 0.83 | 0.69–0.99 | 0.04 |
Systolic blood pressure/10 (mmHg) | 1.53 | 1.22–1.91 | <0.001 |
Diastolic blood pressure/10 (mmHg) | 1.04 | 0.70–1.55 | 0.83 |
Ankle brachial indexd/0.1 | 0.89 | 0.74–1.06 | 0.19 |
Ln protein creatinine ratio (Ln of mg/10 mmol) | 1.21 | 1.00–1.46 | 0.049 |
Total cholesterol/0.1 (mmol/l) | 1.02 | 0.98–1.07 | 0.38 |
LDL cholesterol/0.1 (mmol/l) | 1.02 | 0.97–1.07 | 0.46 |
HDL cholesterol/0.1 (mmol/l) | 0.96 | 0.86–1.07 | 0.42 |
Triglycerides/0.1 (mmol/l) | 1.03 | 1.00–1.07 | 0.07 |
Calcium/0.1 (mmol/l) | 0.60 | 0.41–0.88 | 0.01 |
Phosphate/0.1 (mmol/l) | 1.06 | 0.88–1.27 | 0.56 |
Ln PTH (Ln of pmol/l) | 1.45 | 0.74–2.87 | 0.28 |
Ln FGF23 (Ln of RU/ml) | 1.89 | 1.26–2.82 | 0.002 |
Hemoglobin (mmol/l) | 0.56 | 0.34–0.93 | 0.02 |
Serum albumin (g/l) | 0.87 | 0.78–0.97 | 0.01 |
HbA1c (%) | 1.30 | 0.83–2.04 | 0.25 |
BMI (kg/m2) | 1.00 | 0.91–1.09 | 0.94 |
Smoking | 1.09 | 0.44–2.74 | 0.85 |
Urinary sodium creatinine ratio/0.1 (mmol/mmol) | 1.00 | 0.99–1.01 | 0.52 |
Physical activity guideline adherence | 1.19 | 0.43–3.32 | 0.74 |
Aspirin use | 0.40 | 0.18–0.88 | 0.02 |
Oral anticoagulant drug use | 2.53 | 1.06–6.06 | 0.04 |
Statin use | 0.82 | 0.25–2.75 | 0.75 |
Vitamin D use | 1.46 | 0.68–3.15 | 0.34 |
Antihypertensive drug use | 0.47 | 0.11–1.98 | 0.30 |
Calcium containing phosphate binder use | 0.32 | 0.04–2.38 | 0.27 |
Sevelamer usee
| – | – | – |
Erythropoiesis stimulating agent use | 1.03 | 0.35–3.00 | 0.96 |