Vascular calcification in dialysis patients

Transplant Proc. 2005 Dec;37(10):4183-6. doi: 10.1016/j.transproceed.2005.11.041.

Abstract

The risk factors for vascular calcification (VC) in dialysis patients include duration of dialysis, diabetes mellitus, aging, hyperphosphatemia, hyperparathyroidism, and calcium or vitamin D supplementation. This study was performed to evaluate the prevalence of and risk factors for VC in our dialysis population.

Methods: One hundred twenty-nine chronic dialysis patients underwent plain x-rays of the hands for VC. Patients were grouped as either positive (PVC) or negative (NVC) for VC. Age, gender, duration of dialysis, presence of non-insulin-dependent diabetes mellitus (NIDDM), oral calcium, and 1alpha-hydroxyvitamin D3 supplement, serum levels of calcium (Ca), phosphorus (P), calcium phosphorus product (CaxP), alkaline phosphates (ALP) and intact parathyroid hormone (iPTH) were compared between the two groups.

Results: Thirty-four patients (26.35%) showed VC. There were no differences between PVC and NVC patients for duration of dialysis (38.4 +/- 27.7 for PVC and 34.6 +/- 31.2 months for NVC, P = .80), levels of serum Ca (P = .26), P (P = .19), CaxP (P = .33), ALP (P = .89), or iPTH (P = .24). Similarly, oral calcium and 1alpha-hydroxyvitamin D3 intake were not different between the two groups (P = .971 and P = .3710 respectively). Compared to NVC patients, PVC patients were older (56.3 +/- 10.4 versus 47.5 +/- 16.1 years, P = .008) and had a greater incidence of NIDDM (17/34 PVC and diabetic versus 20/95 NVC, P = .001). In conclusion, for patients with a medium length of dialysis, the duration of dialysis as well as the doses of calcium salts and of 1alpha-hydroxyvitamin D3 were not significantly associated with vascular calcifications, but it was not possible to exclude a role for these and other factors in patients with longer dialysis.

MeSH terms

  • Alkaline Phosphatase / blood
  • Calcinosis / epidemiology*
  • Calcitriol / therapeutic use
  • Calcium / blood
  • Diabetic Nephropathies / therapy
  • Dietary Supplements
  • Female
  • Humans
  • Hyperparathyroidism / complications
  • Hyperparathyroidism / epidemiology
  • Male
  • Middle Aged
  • Peritoneal Dialysis / adverse effects*
  • Phosphates / blood
  • Phosphorus / blood
  • Prevalence
  • Renal Dialysis / adverse effects*
  • Risk Factors
  • Time Factors
  • Vascular Diseases / epidemiology*

Substances

  • Phosphates
  • Phosphorus
  • Alkaline Phosphatase
  • Calcitriol
  • Calcium