Abstract: TH-PO319
Can Cardiovascular Risk Score Calculators Be Used for Nondiabetic Peritoneal Dialysis Patients?
Session Information
- Peritoneal Dialysis: CVD, Fluid, Nutrition
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Andronesi, Andreea Gabriella, Fundeni Clinical Institute, Bucharest, Romania
- Obrisca, Bogdan, Fundeni Clinical Institute, Bucharest, Romania
- Sorohan, Bogdan Marian, Fundeni Clinical Institute, Bucharest, Romania
- Lupusoru, Gabriela, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Andronesi, Danut, Fundeni Clinical Institute, Bucharest, Romania, Romania
- Lupusoru, Mircea, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Ismail, Gener, Fundeni Clinical Institute, Bucharest, Romania
Background
Cardiovascular diseases caries a significant burden upon peritoneal dialysis (PD) patients. Despite overwhelming data regarding the usefulness of cardiovascular risk score calculators in the general population, only very few studies addressed this issue in PD.
Methods
We performed a prospective study. Three risk score calculators were evaluated at inclusion in the study: SCORE chart, Framingham and simplified Framingham risk score calculators. We excluded diabetic patients since they are already at increased cardiovascular risk. Predictive power for cardiovascular diseases was assessed using Receiver Operating Characteristic curve analysis by IBM SPSS ver. 20.0.
Results
We included 246 non-diabetic patients (118F), mean age 56.3 + 15.7 years in stable PD for at least 6 months. Mean follow up time was 6.2 years. All the three risk scores where significantly higher in patients with renal hypertensive disease, compared to patients with glomerulonephritis, tubular interstitial diseases and other end stage renal disease etiologies (Table 1). The two Framingham risk scores were also significantly higher in patients with subclinical atherosclerosis as appreciated by an intima-media thickness (IMT) >0.9 mm at carotid ultrasound and the best predictive value for an IMT >0.9 mm was obtained by Framingham risk score (Tables 2 and 3). The best predictive value for developing acute coronary syndrome (ACS), heart failure (HF) and cardiovascular death (CvD) during the follow up period was obtained by Framingham risk score (AUC 0.887 for ACS, 0.731 for HF, and 0.809 for CvD), and by simplified Framingham risk score for ischemic stroke (AUC 0.883).
Conclusion
Risk score calculators, especially the Framingham one, may be useful in non-diabetic PD patients to both predict subclinical atherosclerosis and established cardiovascular disease and thus improve patients’ management. Our results need to be validated in larger multi-center studies.