Wever, since the majority of subjects included in most previous studies were ESRD patients on hemodialysis (HD), little is known about the prevalence, natural history, and prognostic value of vascular calcification in peritoneal dialysis (PD) patients. In the present study, we investigated the prevalence of AoAC at PD initiation and the frequencies of AoAC progression or regression during the first year after PD. The impact of AoAC progression on all-cause and cardiovascular mortality was also determined.tion procedure. Patients were weighed in light clothing and height was measured with no shoes. Body mass index (BMI) was calculated as weight/height2 (kg/m2). Blood was drawn after a 12-hour overnight fasting, and the following laboratory data were measured from blood samples: hemoglobin, blood urea nitrogen, creatinine, calcium, phosphorus, albumin, total cholesterol, triglyceride, low density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, and intact parathyroid hormone (iPTH) concentrations. In addition, high sensitivity Creactive protein (hs-CRP) levels were determined by a latexenhanced immunoephelometric method using a BN II analyzer (Dade Behring, Newark, DE, USA). To reflect the actual situation, usual overnight dialysate volume and glucose concentrations were not changed for this study. Kt/V urea was determined from the total loss of urea nitrogen in spent dialysate using PD Adequest 2.0 for Windows order Peptide M software (Baxter Healthcare, Deerfield, Illinois, USA). The modified peritoneal equilibration test was performed with 4.25 glucose dialysis solution as described previously [20] and the dialysate-to-plasma creatinine (D/P Cr) and glucose (D/ D0 glucose) concentration ratios at 4 hours of dwell were used to describe the peritoneal transport characteristics; high, high average, low average, and low.Assessment of AoAC by Chest X-rayTo determine AoAC extent, two trained medical doctors blinded to the patients’ clinical data reviewed posterior-anterior plain chest X-rays taken at the start of PD using a specific scale developed by Ogawa et al [16]. This scale, which divides the aortic 1655472 arch into 16 sections by circumference, was attached to the aortic arch on chest X-rays and the number of sectors was divided by 16. AoAC scores (AoACS) were calculated after multiplication by 100 to express results as a percentage. To confirm the intrareader variability, randomly selected 100 chest X-rays were reexamined by the same reader. The median intra-class correlation coefficient for AoACS was 0.91 [95 confidence interval (CI): 0.71 to 0.99] and 0.90 (95 CI: 0.69 to 0.98) in two readers. In addition, any discrepancies between the two observers were resolved by an independent third reader. Progression of AoAC was defined as an increase in AoACS on the follow-up chest X-ray taken 1 year after PD initiation.Methods Ethics StatementThe study was carried out in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Yonsei University Health System Clinical Trial Center. We obtained 58-49-1 site informed written consent from all participants involved in our study.PatientsAll consecutive ESRD patients over 18 years of age who started PD at Yonsei University Health System between January 2005 and June 2010 26001275 were initially included in this prospective observational study. Among a total of 530 incident PD patients, patients with PD duration of less than 3 months, active infection, malignancy, and decompens.Wever, since the majority of subjects included in most previous studies were ESRD patients on hemodialysis (HD), little is known about the prevalence, natural history, and prognostic value of vascular calcification in peritoneal dialysis (PD) patients. In the present study, we investigated the prevalence of AoAC at PD initiation and the frequencies of AoAC progression or regression during the first year after PD. The impact of AoAC progression on all-cause and cardiovascular mortality was also determined.tion procedure. Patients were weighed in light clothing and height was measured with no shoes. Body mass index (BMI) was calculated as weight/height2 (kg/m2). Blood was drawn after a 12-hour overnight fasting, and the following laboratory data were measured from blood samples: hemoglobin, blood urea nitrogen, creatinine, calcium, phosphorus, albumin, total cholesterol, triglyceride, low density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, and intact parathyroid hormone (iPTH) concentrations. In addition, high sensitivity Creactive protein (hs-CRP) levels were determined by a latexenhanced immunoephelometric method using a BN II analyzer (Dade Behring, Newark, DE, USA). To reflect the actual situation, usual overnight dialysate volume and glucose concentrations were not changed for this study. Kt/V urea was determined from the total loss of urea nitrogen in spent dialysate using PD Adequest 2.0 for Windows software (Baxter Healthcare, Deerfield, Illinois, USA). The modified peritoneal equilibration test was performed with 4.25 glucose dialysis solution as described previously [20] and the dialysate-to-plasma creatinine (D/P Cr) and glucose (D/ D0 glucose) concentration ratios at 4 hours of dwell were used to describe the peritoneal transport characteristics; high, high average, low average, and low.Assessment of AoAC by Chest X-rayTo determine AoAC extent, two trained medical doctors blinded to the patients’ clinical data reviewed posterior-anterior plain chest X-rays taken at the start of PD using a specific scale developed by Ogawa et al [16]. This scale, which divides the aortic 1655472 arch into 16 sections by circumference, was attached to the aortic arch on chest X-rays and the number of sectors was divided by 16. AoAC scores (AoACS) were calculated after multiplication by 100 to express results as a percentage. To confirm the intrareader variability, randomly selected 100 chest X-rays were reexamined by the same reader. The median intra-class correlation coefficient for AoACS was 0.91 [95 confidence interval (CI): 0.71 to 0.99] and 0.90 (95 CI: 0.69 to 0.98) in two readers. In addition, any discrepancies between the two observers were resolved by an independent third reader. Progression of AoAC was defined as an increase in AoACS on the follow-up chest X-ray taken 1 year after PD initiation.Methods Ethics StatementThe study was carried out in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Yonsei University Health System Clinical Trial Center. We obtained informed written consent from all participants involved in our study.PatientsAll consecutive ESRD patients over 18 years of age who started PD at Yonsei University Health System between January 2005 and June 2010 26001275 were initially included in this prospective observational study. Among a total of 530 incident PD patients, patients with PD duration of less than 3 months, active infection, malignancy, and decompens.
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