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首页> 外文期刊>Journal of nephrology. >High-dose calcitriol therapy and progression of cardiac vascular calcifications.
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High-dose calcitriol therapy and progression of cardiac vascular calcifications.

机译：大剂量骨化三醇治疗和心脏血管钙化的进展。

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BACKGROUND: Dialysis patients show a very high prevalence of cardiovascular complications, affected as they are with abnormal and accelerated vascular calcifications and, eventually, calcium and phosphorous metabolism disorders. Multislice computed tomography (MSCT) provides a reproducible, high-resolution imaging of calcium contained in cardiac arteries, measured by Agatston score. The aim of the present study was to evaluate the influence of high-dose and low-dose calcitriol therapy on the progression of cardiac vascular calcifications in dialyzed patients. METHODS: We enrolled 36 dialyzed patients in a prospective study, including an interventional period of 12 months and a follow-up period of 12 months. Eighteen protocol patients received intravenous pulses of high-doses calcitriol at the end of dialytic treatment and sevelamer hydrochloride therapy. Control patients received low-dose calcitriol and sevelamer hydrochloride as well. Two MSCT scans were performed: 1 at the start of the study and 1 atthe end of follow-up, and Agatston score was calculated at both examinations. RESULTS: At first examination, protocol patients showed almost the same level of cardiac vascular calcification as control patients. At the second MSCT, statistically significantly higher values of Agatston score were recorded for all patients. Indeed, patients who showed higher baseline values developed worse calcifications as recorded at the end of follow-up, both in the protocol and control group. CONCLUSIONS: Our data show that baseline level is strongly predictive of vascular calcification progression, and, moreover, there is no association between calcitriol administered doses and the progression of cardiac vascular calcification.
机译：背景：透析患者显示出非常高的心血管并发症发生率，因为他们患有异常和加速的血管钙化，并最终受到钙和磷代谢紊乱的影响。多层计算机断层扫描（MSCT）可通过Agatston评分对心脏动脉中所含钙进行可再现的高分辨率成像。本研究的目的是评估高剂量和低剂量骨化三醇治疗对透析患者心脏血管钙化进展的影响。方法：我们在一项前瞻性研究中纳入了36位透析患者，包括12个月的介入期和12个月的随访期。在透析治疗和盐酸司维拉姆治疗结束时，有18名协议患者接受了静脉注射大剂量骨化三醇。对照患者也接受了小剂量骨化三醇和司维拉姆盐酸盐的治疗。进行了两次MSCT扫描：在研究开始时进行1次扫描，在随访结束时进行1次扫描，两次检查均计算Agatston评分。结果：初诊时，方案患者显示出与对照患者几乎相同的心血管钙化水平。在第二次MSCT中，所有患者的Agatston评分均在统计学上显着提高。实际上，方案和对照组中，基线值较高的患者在随访结束时均出现了较差的钙化。结论：我们的数据显示基线水平强烈预测血管钙化进展，此外，骨化三醇的给药剂量与心脏血管钙化进展之间没有关联。

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