Vascular calcification of the aortic arch and peripheral artery in haemodialysis patients with and without diabetes mellitus.
OBJECTIVE
to look for differences in clinical characteristics, and differences in the role of mineral metabolism disorders and inflammation in diabetic and non diabetic patients.


METHODS
subjects were 127 patients on maintenance haemodialysis: 46 with DM and 81 without. Vascular calcification of the aortic arch and peripheral artery were recorded qualitatively using x-ray of the chest and lower extremities. Clinical characteristics and laboratory values were taken from the medical records.


RESULTS
the overall prevalence of vascular calcification was similar in our haemodialysis patients, with or without DM (26.1% vs 25.9%). The diabetic patients were in general of older age (58.5+10.3 vs 51.6+12.6 years, p<0.05), had lower diastolic BP (80+14 vs 86+14 mmHg, p<0.05), and higher prevalence of isolated peripheral artery calcification (13% vs 2.5%, p<0.05). Vascular calcification in diabetic haemodialysis patients occurred at the same rate in spite of a lower serum P, (5.7+1.5 vs 6.9+1.5 mg/dl, p<0.05), and Ca X P product (52.3+14.5 vs 60.7+14.5, p<0.05), and shorter HD vintage (1.3+0.9 vs 3.2+3.3 years, p<0.05). In a sub analysis comparing patients according to presence and location of vascular calcification, patients with vascular calcification of the peripheral artery only were mostly diabetics (75%), had lower serum Ca (8.6+0.5mg/dl), P (6.7+0.6mg/dl), Ca x P product (57.4+5.10 mg2/dl2), and higher serum CRP (1.70+1.59mg/dl).


CONCLUSIONS
diabetic patients on HD may be at higher risk for peripheral artery calcification, at lower serum Ca, P, and Ca X P product. The higher CRP may indicate a higher inflammatory status, which is probably the major risk factor for vascular calcification of the peripheral artery.
Sutandar
Widodo
W
Laboratorium Dialysis National Air force Hospital (RUSPAU), Faculty of Medicine Krida Wacana Christian University Jakarta. Jl. Merpati #2, Halim Perdana Kusuma, Jakarta. sutandar@yahoo.com
D001018:Aortic Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000378:metabolism*; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors
D002097:C-Reactive Protein