title: Evaluation of aortic arch calcification in hemodialysis patients.
abstract: BACKGROUND
  In the general population, aortic arch calcification (AAC) is related to cardiovascular (CV) disease. Vascular calcifications are common findings in dialysis patients; therefore, we carried out a retrospective study evaluating which risk factors are associated to AAC in stable hemodialysis (HD) patients.
  
  
  METHODS
  Standard posterior-anterior chest radiographs, performed the day after the midweek HD session in 132 patients (mean age 65 +/- 12 yrs) who had been on renal replacement therapy (RRT) for 33 months (range 1-471), were analyzed. Cardiothoracic ratio (CTR) was also calculated.
  
  
  RESULTS
  AAC was detected in 51% of patients. They were older (68 +/- 8 vs. 62 +/- 14 yrs; p = 0.003), were on RRT for longer (51 (range 2-471) vs. 22 (range 1-195) months; p = 0.0001), had greater CTR (54 (32-71) vs. 50% (40-65); p = 0.034) and higher prevalence of peripheral vascular disease (PVD) (40 vs. 17%; p = 0.049), whilst body weight was lower (62 +/- 14 vs. 68 +/- 14 kg; p = 0.04) than those without AAC. On the contrary, sex, diabetes frequency, smoking habit, history of hypertension and hyperphosphatemia, cerebrovascular and ischemic heart disease (IHD), blood pressure (BP) and antihypertensive therapy, lipids, albumin, degree of anemia, calcium, phosphate and their product were no different between the two groups. Logistic regression analysis showed that age (odds ratio (OR) 1.069 95% confidence interval (95% CI) 1.02-1.11; p = 0.003), length of time on RRT (OR 1.02 95% CI 1.01-1.03; p = 0.0002), calcium-phosphate product (OR 1.03 95% CI 1.007-1.07; p = 0.016), systolic BP (OR 1.03 95% CI 1.005-1.06; p = 0.02) and PVD (OR 3.08 95% CI 1.17-8.06; p = 0.02) were independently associated to AAC.
  
  
  CONCLUSIONS
  We conclude that AAC is related to atherosclerosis and to renal failure-related CV risk factors. A careful evaluation of a frequently performed investigation is useful in CV disease risk stratification in HD patients.
authors: Department of Nephrology, Arcispedale S. Anna, Ferrara, Italy. hrfabbia@tin.it
authors: Fabio
authors: F
authors: Fabbian
authors: Carlo
authors: C
authors: Catalano
authors: Valentina
authors: V
authors: Orlandi
authors: Maria Maddalena
authors: MM
authors: Conte
authors: Antonio
authors: A
authors: Lupo
authors: Luigi
authors: L
authors: Catizone
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013902:Radiography, Thoracic; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors