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Vascular calcification and cardiac function according to residual renal function in patients on hemodialysis with urination.

Vascular calcification and cardiac function according to residual renal function in patients on hemodialysis with urination.
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Shin DH, Lee YK, Oh J, Yoon JW, Rhee SY, Kim EJ, Ryu J, Cho A, Jeon HJ, Choi MJ, Noh JW,


Shin DH, Lee YK, Oh J, Yoon JW, Rhee SY, Kim EJ, Ryu J, Cho A, Jeon HJ, Choi MJ, Noh JW, (click to view)

Shin DH, Lee YK, Oh J, Yoon JW, Rhee SY, Kim EJ, Ryu J, Cho A, Jeon HJ, Choi MJ, Noh JW,

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PloS one 2017 09 2712(9) e0185296 doi 10.1371/journal.pone.0185296
Abstract
BACKGROUND
Vascular calcification is common and may affect cardiac function in patients with end-stage renal disease (ESRD). However, little is known about the effect of residual renal function on vascular calcification and cardiac function in patients on hemodialysis.

METHODS
This study was conducted between January 2014 and January 2017. One hundred six patients with residual renal function on maintenance hemodialysis for 3 months were recruited. We used residual renal urea clearance (KRU) to measure residual renal function. First, abdominal aortic calcification score (AACS) and brachial-ankle pulse wave velocity (baPWV) were measured in patients on hemodialysis. Second, we performed echocardiography and investigated new cardiovascular events after study enrollment.

RESULTS
The median KRU was 0.9 (0.3-2.5) mL/min/1.73m2. AACS (4.0 [1.0-10.0] vs. 3.0 [0.0-8.0], p = 0.05) and baPWV (1836.1 ± 250.4 vs. 1676.8 ± 311.0 cm/s, p = 0.01) were significantly higher in patients with a KRU < 0.9 mL/min/1.73m2 than a KRU ≥ 0.9 mL/min/1.73m2. Log-KRU significantly negatively correlated with log-AACS (ß = -0.29, p = 0.002) and baPWV (ß = -0.19, P = 0.05) after factor adjustment. The proportion of left ventricular diastolic dysfunction was significantly higher in patients with a KRU < 0.9 mL/min/1.73m2 than with a KRU ≥ 0.9 mL/min/1.73m2 (67.9% vs. 49.1%, p = 0.05). Patients with a KRU < 0.9 mL/min/1.73m2 showed a higher tendency of cumulative cardiovascular events compared to those with a KRU ≥ 0.9 ml/min/1.73m2 (P = 0.08). CONCLUSIONS
Residual renal function was significantly associated with vascular calcification and left ventricular diastolic dysfunction in patients on hemodialysis.

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