机构：[1]Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.江苏省人民医院[2]Department of Nephrology, the Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, China.[3]Department of Nephrology, Nanjing Tongren Hospital, Nanjing, China.[4]Center for Medical Big Data, Nanjing Drum Tower Hospital, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.[5]Department of Nephrology, Nanjing BenQ Medical Center, Nanjing, China.[6]Department of Critical Medicine, Geriatric Hospital of Nanjing Medical University, Nanjing, China.[7]Department of Imaging, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.江苏省人民医院
The Agatston coronary artery calcification score (CACS) is an assessment index for coronary artery calcification (CAC). This study aims to explore the characteristics of CAC in end-stage kidney disease (ESKD) patients and establish a predictive model to assess the risk of severe CAC in patients.CACS of ESKD patients was assessed using an electrocardiogram-gated coronary computed tomography (CT) scan with the Agatston scoring method. A predictive nomogram model was established based on stepwise regression. An independent validation cohort comprised of patients with ESKD from multicentres.369 ESKD patients were enrolled in the training set, and 127 patients were included in the validation set. In the training set, the patients were divided into three subgroups: no calcification (CACS = 0, n = 98), mild calcification (0 < CACS ≤ 400, n = 141) and severe calcification (CACS > 400, n = 130). Among the four coronary branches, the left anterior descending branch (LAD) accounted for the highest proportion of calcification. Stepwise regression analysis showed that age, dialysis vintage, β-receptor blocker, calcium-phosphorus product (Ca × P), and alkaline phosphatase (ALP) level were independent risk factors for severe CAC. A nomogram that predicts the risk of severe CAC in ESKD patients has been internally and externally validated, demonstrating high sensitivity and specificity.CAC is both prevalent and severe in ESKD patients. In the four branches of the coronary arteries, LAD calcification is the most common. Our validated nomogram model, based on clinical risk factors, can help predict the risk of severe coronary calcification in ESKD patients who cannot undergo coronary CT analysis.
基金：
This work was funded by the National Natural Science Foundation of China [81270408, 81570666], International Society of Nephrology (ISN) Clinical Research Program [18-01-0247], Jiangsu Provincial Special Program of Medical Science [BL2014080], Construction Program of Jiangsu Provincial Clinical Research Center Support System [BL2014084], Chinese Society of Nephrology [13030300415], Jiangsu Province Key Medical Personnel Project [RC201162, ZDRCA2016002], Six Major Talents Summit of Jiangsu Province [2010-WS-026].
第一作者机构：[1]Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.[2]Department of Nephrology, the Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, China.
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通讯作者：
推荐引用方式(GB/T 7714)：
Tang Xinfang,Qian Hanyang,Lu Shijiu,et al.Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients[J].Renal Failure.2024,46(2):2365393.doi:10.1080/0886022X.2024.2365393.
APA：
Tang Xinfang,Qian Hanyang,Lu Shijiu,Huang Hui,Wang Jing...&Wang Ningning.(2024).Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients.Renal Failure,46,(2)
MLA：
Tang Xinfang,et al."Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients".Renal Failure 46..2(2024):2365393
