The link between bone and coronary calcifications in CKD-5 patients on haemodialysis

Nephrol Dial Transplant. 2011 Mar;26(3):1010-5. doi: 10.1093/ndt/gfq491. Epub 2010 Aug 13.

Abstract

Background: Vascular calcifications are frequent in Stage 5 chronic kidney disease (CKD-5) patients receiving haemodialysis. The current study was designed to evaluate the associations between bone turnover/volume and coronary artery calcifications (CAC).

Methods: In 207 CKD-5 patients, bone biopsies, multislice computed tomography of the coronary arteries and blood drawings for relevant biochemical parameters were done. The large number of CKD-5 patients enrolled allowed separate evaluation of patients with CAC versus patients without CAC and adjustment for traditional and non-traditional risk factors for CAC.

Results: When all patients were analysed, associations were found between CAC and bone turnover, bone volume, age, gender and dialysis vintage. When only patients with CAC were included, there was a U-shaped relationship between CAC and bone turnover, whilst the association with bone volume was lost. In these patients, the relationship of CAC with age, gender and dialysis vintage remained.

Conclusions: Beyond the non-modifiable risk factors of age, gender and dialysis vintage, these data show that bone abnormalities of renal osteodystrophy amenable to treatment should be considered in the management of patients with CAC.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone Diseases / etiology*
  • Bone Remodeling
  • Calcification, Physiologic
  • Calcinosis / etiology*
  • Coronary Artery Disease / etiology*
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation
  • Kidney Failure, Chronic / complications*
  • Male
  • Malnutrition
  • Middle Aged
  • Prognosis
  • Renal Dialysis / adverse effects*
  • Risk Factors
  • Survival Rate