title: Vascular access calcification predicts mortality in hemodialysis patients.
abstract: Vascular calcification is a recognized risk factor for cardiovascular mortality in patients with end-stage renal disease. The aim of this study was to identify risk factors for vascular access calcification and to determine if patients with this disorder are at increased risk of death. Vascular access calcification was found in 49 of 212 hemodialysis patients as measured by plain X-ray (arteriovenous fistula or synthetic graft) in two dimensions. Male gender, diabetes mellitus, and length of time on dialysis were independent predictors for access calcification determined by logistic regression multivariate analysis. Serum parameters were not independently related to access calcification. Kaplan-Meier analysis showed an increased mortality risk, and Cox regression analysis confirmed that vascular access calcification was an independent mortality predictor. Our study suggests that detection of vascular access calcification is a cost-effective method to identify patients at increased mortality risk.
authors.affiliation: Department of Nephrology and Clinical Immunology, RWTH University Hospital Aachen, Aachen, Germany. gschlieper@ukaachen.de
authors.forename: Georg
authors.initials: G
authors.lastname: Schlieper
authors.forename: Thilo
authors.initials: T
authors.lastname: Krüger
authors.forename: Zivka
authors.initials: Z
authors.lastname: Djuric
authors.forename: Tatjana
authors.initials: T
authors.lastname: Damjanovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Markovic
authors.forename: Leon J
authors.initials: LJ
authors.lastname: Schurgers
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Brandenburg
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
authors.forename: Sinisa
authors.initials: S
authors.lastname: Dimkovic
authors.forename: Markus
authors.initials: M
authors.lastname: Ketteler
authors.forename: Diana C
authors.initials: DC
authors.lastname: Grootendorst
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
authors.forename: Nada
authors.initials: N
authors.lastname: Dimkovic
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002114:Calcinosis / Q000150:complications* / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D009026:Mortality; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors