Vascular calcification in the uremic patient: a cardiovascular risk?
BACKGROUND
Several factors suggest that the presence of vascular calcification (VC) is associated with a high risk of cardiac events in uremic patients. The aim of this study was to analyze the influence of VC on cardiac morbidity and mortality in our hemodialysis (HD) patients.


METHODS
We studied 79 patients on HD: 43 males, mean age 48 +/- 15 years old, mean time on HD 83 +/- 63 months. The presence of VC was evaluated by radiologic series. Other cardiovascular risk factors analyzed were arterial hypertension, diabetes mellitus, obesity, cigarette smoking, anemia, and dyslipidemia. All patients underwent M-mode, two-dimensional, Doppler echocardiography. Patients were followed for two years. During this time, clinical information collected included predialysis blood pressure, incidence of ischemic heart disease, episodes of congestive heart failure, and mortality due to cardiovascular event.


RESULTS
VC was observed in 55.7% of patients. Left ventricular hypertrophy, diastolic dysfunction, and cardiac valve calcification were significantly associated with VC. Ischemic heart disease (71.4% vs. 28.6%) and episodes of cardiac failure (0.41 vs. 0.18 per year; P < 0.05) appeared more frequently in the patient group with VC. VC was present in 80.6% of patients who developed episodes of heart failure. Eight patients died from cardiac disease; each of them had VC.


CONCLUSIONS
The presence of VC can help to identify those HD patients with a higher cardiovascular risk.
Salgueira
Mercedes
M
Nephrology and Cardiology Services, Virgen Macarena University Hospital, Sevilla, Spain. apalma@hvm.sas.junta-andalicina.es
del Toro
Nuria
N
Moreno-Alba
Rafael
R
Jiménez
Elena
E
Aresté
Nuria
N
Palma
Alfonso
A
D000368:Aged; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging