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Kidney Week

Abstract: TH-PO284

Framingham's Cardiovascular Disease (CVD) Risk Score (FRS) and Its Components as Predictors of Mortality in Peritoneal Dialysis (PD) Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Zhimin, Chen, Zhejiang University, Hang Zhou, China
  • Qureshi, Abdul Rashid Tony, Karolinska Institutet, Huddinge, STOCKHOLM, Sweden
  • Zhang, Xiaohui, Zhejiang University, Hangzhou, China
  • Han, Fei, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZHEJIANG, China
  • Xie, Xishao, Kidney Disease Center, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
  • Stenvinkel, Peter, Karolinska University Hospital Huddinge, Stockholm, Sweden
  • Lindholm, Bengt, Karolinska Institutet, Huddinge, STOCKHOLM, Sweden
  • Chen, Jianghua, Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZheJiang, China
Background

Non-traditional risk factors (e g inflammation and oxidative stress) contribute to the high mortality risk due to CVD in patients (pts) with chronic kidney disease (CKD). However, the impact of traditional risk factors represented by FRS, and its components age, sex, hypertension, diabetes mellitus (DM), smoking and hyperlipidemia, is less well documented.We analyzed the associationof FRS with mortality in PD pts.

Methods

In 1276 incident PD pts (median age 50 years, 56 % males), FRS andmetabolicbiomarkers linked to CVD were analysedat baseline. Associations of FRS and its components with all-cause and CVD-related mortality during follow up of up to 60 months (median 44 months) was analysed using regression models with transplantation as competing risk.

Results

Pts in the high tertile of FRS were predominately older men with DM, CVD and high BMI, and low serum creatinine, albumin and parathyroid hormone (iPTH).In linear regression model, FRS associated with CVD, BMI, Hb, iPTH, alkaline phosphatase (ALP), calcium and albumin after adjustments for confounders. All-cause mortality risk(expressed as crude sHR) associated with 1-SD higher FRS (sHR 1.50), and its components, higher age (sHR 2.63), female gender (sHR 0.67), and DM (sHR 2.40), and crude CVD-mortality riskwith 1-SD higher FSR (sHR 1.64), and age (sHR 2.89), DM (sHR 3.41) andcholesterol(sHR 1.08). In competing-risks regression analysis, high vs low tertile of FRS, independently associated with all-cause, sHR 3.65(95% CI 2.07 - 6.44) and CVD, sHR 3.28 (95% CI 1.45 - 7.11) mortality risk after adjusting for CVD, year of recruitment, and 1-SD higher: BMI, creatinine, uric acid, calcium, phosphate, ALP, iPTH, triglycerides, glucose, Hb, ASAT and ALAT.

Conclusion

FRS is independently associated with mortality risk in PD pts, underlining the importance of traditional risk factors in CKD. FRS is a useful risk assessment tool for predicting clinical outcomes in PD pts.