Affiliations: Division of Nephrology, Department of Internal
Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University
College of Medicine, Kaohsiung, Taiwan | Division of Cardiology, Department of Internal
Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University
College of Medicine, Kaohsiung, Taiwan | Dpartment of Neurology,Kaohsiung Medical University,
Kaohsiung, Taiwan
Note: [] Corresponding author: Chien-Te Lee, Division of Nephrology,
Department of Internal Medicine, Kaohsiung Chang-Gung Memorial Hospital, 123,
Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan. Tel.: +886 7 7317123
EXT 8306; Fax: +886 7 7322402; E-mail: [email protected]
Abstract: BACKGROUND: Cardiovascular calcification, including arterial intimal
and medial calcification (AIC and AMC) and valvular calcification (VC) are
important predictors of outcome in chronic dialysis patients. We aimed to
compare their prevalence and analyze respective risk factors in hemodialysis
(HD) patients. METHODS: A total of 81 HD patients were enrolled. Vascular
calcification was assessed by plain film radiography of the pelvis and VC was
diagnosed by echocardiography. Demographic data was reviewed and serum levels
of calcification-relevant biomarkers were determined. Patients with and without
calcification were then compared. RESULTS: The prevalence study indicated that 36 patients had AIC
(44.4%), 17 had AMC (21%) and 60 (74.1%) had VC. Patients with vascular
calcification were older, and had a higher prevalence of diabetes. Their IL-6,
osteoprotegerin, and uric acid levels were higher. Serum fetuin-A was lower in
patients with VC. Logistic regression analysis revealed age, uric acid and
diabetes to be independently associated with AIC; uric acid, diabetes and
osteoprotegerin with AMC. Fetuin-A was the sole associate of VC. CONCLUSIONS: It is concluded that the prevalence of cardiovascular
calcification in chronic HD patients was high with cardiac valve involvement
more frequent. Factors associated with different type of calcification were not
identical. Changes in biomarkers may represent clinical clues for assessment of
cardiovascular calcification in HD patients.
