Carotid atherosclerosis is a predictor of coronary calcification in chronic haemodialysis patients.
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.
Yildiz
Alaattin
A
Vanderbilt University Medical Center, Department of Internal Medicine, Division of Nephrology, S-3223, Medical Center North, Nashville, TN 37232-2372, USA. alaattiny@hotmail.com
Tepe
Savas
S
Oflaz
Huseyin
H
Yazici
Halil
H
Pusuroglu
Hamdi
H
Besler
Mine
M
Ark
Ergin
E
Erzengin
Faruk
F
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
D010281:Parathyroid Hormone