Cardiac calcifications in hemodialysis patients assessed with spiral computed tomography.
OBJECTIVE
Cardiac disease is a major cause of mortality in uremic patients. The aim of this paper was to evaluate cardiac calcium content in uremic patients with multislice computed tomography (MSCT).


METHODS
The study has been carried out on 120 uremic and 28 nonuremic patients affected by cardiovascular disease. Serum calcium, phosphorus, calcium-phosphate product, intact PTH were assayed. Several lipidic and nutritional parameters were measured. Calcification values obtained with the MSCT were reported in terms of Agatson scores.


RESULTS
We found that the average score values in cohort on uremic was 10 times higher than in nonuremic patients (score values 3.389 vs 328). Cardiac calcification score was found to be correlated significantly to age (P=0.006), HD age (P=0.010), serum calcium (P=0.006), iPTH (P=0.004). Multiregression analysis (MRA) with the cardiac score as dependent variable selected the following variables (R(2) 0.612): age (P=0.002), HD age (P=0.010), serum cholesterol (P<0.000), triglycerides (P=0.001) and inversely HDL cholesterol (P=0.001) and non-HDL cholesterol (P=0.001) as predictive variables for cardiac score. By comparing patients with scores lower and higher than 400, the group with score <400 showed a significantly lower age (P=0.0001), HD vintage (P=0.01) and a significantly higher serum cholesterol (P=0.009), HDL cholesterol (P=0.05) and non-HDL cholesterol (P=0.05).


CONCLUSIONS
The MSCT could help in identifying and stratifying high-risk patients to implement preventive strategies. The control of mineral metabolism and of lipid levels is important in prevention of arterial calcification in uremic patients.
Manni
M
M
Department of Nephrology, S. Giovanni Addolorata Hospital, Rome, Italy. micaela.manni@tin.it
Coen
G
G
Balducci
A
A
Morosetti
M
M
Jankovic
L
L
Mantella
D
D
Vega
A
A
Naticchia
A
A
Sorbo
G
G
Taccone Gallucci
M
M
Pierantozzi
A
A
Simonetti
G
G
Splendiani
G
G
D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D036542:Tomography, Spiral Computed