title: Carotid atherosclerosis is a predictor of coronary calcification in chronic haemodialysis patients.
abstract: BACKGROUND
  Coronary artery calcification scores (CACS) calculated by electron beam computed tomography (EBCT) have been correlated with atherosclerotic burden in the non-uraemic population. However, the validity of this test in chronic haemodialysis patients (HD) is currently uncertain. In the present cross-sectional study, associations between carotid atherosclerosis and coronary calcification in HD patients are investigated.
  
  
  METHODS
  We studied 79 chronic HD patients (39 male, 40 female; mean age, 45+/-12 years). The mean time on HD was 68+/-54 months (range, 6-187 months). In these patients, we measured serum calcium, phosphorus, total cholesterol, cholesterol subgroups and iPTH levels. EBCT, echocardiography, and high-resolution B-mode carotid Doppler ultrasonography were also performed.
  
  
  RESULTS
  Plaque-positive HD patients had significantly higher CACS than plaque-negative patients (851+/-199 vs 428+/-185, mean+/-SE, P = 0.006). Coronary calcification scores were correlated with serum phosphorus (r = 0.37; P = 0.001). Only 8 of the 24 HD patients without coronary calcification had carotid plaques (33%), whereas 34 of the 53 patients with coronary calcification had carotid plaques (64%) (P = 0.015). Carotid plaque scores were correlated with CACS (r = 0.40; P = 0.001). A stepwise linear regression (model r = 0.72; P<0.001) revealed that CACS (log-transformed data of CACS) was associated with age (P<0.001), time on dialysis (P = 0.004), serum phosphorus level (P = 0.016) and carotid plaque scores (P = 0.037).
  
  
  CONCLUSIONS
  Atherosclerosis is independently associated with coronary artery calcification and with hyperphosphataemia in chronic HD patients. CACS appeared to be predictive of both coronary atherosclerosis and carotid atherosclerosis.
authors.affiliation: Vanderbilt University Medical Center, Department of Internal Medicine, Division of Nephrology, S-3223, Medical Center North, Nashville, TN 37232-2372, USA. alaattiny@hotmail.com
authors.forename: Alaattin
authors.initials: A
authors.lastname: Yildiz
authors.forename: Savas
authors.initials: S
authors.lastname: Tepe
authors.forename: Huseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Halil
authors.initials: H
authors.lastname: Yazici
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Mine
authors.initials: M
authors.lastname: Besler
authors.forename: Ergin
authors.initials: E
authors.lastname: Ark
authors.forename: Faruk
authors.initials: F
authors.lastname: Erzengin
mesh_terms: D002114:Calcinosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed
chemical_list: D010281:Parathyroid Hormone