Vascular access calcification predicts mortality in hemodialysis patients.
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.
Schlieper
Georg
G
Department of Nephrology and Clinical Immunology, RWTH University Hospital Aachen, Aachen, Germany. gschlieper@ukaachen.de
Krüger
Thilo
T
Djuric
Zivka
Z
Damjanovic
Tatjana
T
Markovic
Natasa
N
Schurgers
Leon J
LJ
Brandenburg
Vincent M
VM
Westenfeld
Ralf
R
Dimkovic
Sinisa
S
Ketteler
Markus
M
Grootendorst
Diana C
DC
Dekker
Friedo W
FW
Floege
Jürgen
J
Dimkovic
Nada
N
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