Risk factors for cardiovascular calcifications in non-diabetic Caucasian haemodialysis patients.
OBJECTIVE
Dialysis patients display an increased mortality which is associated with cardiovascular calcifications. Diabetes mellitus and ethnicity are known factors that affect the extent of cardiovascular calcifications. However, most studies have investigated mixed cohorts with diabetics and/or mixed ethnicity.


METHODS
Cardiovascular calcifications were assessed in non-diabetic Caucasian haemodialysis patients by the semiquantitative Adragao calcification score (X-ray pelvis and hands) and a novel composite calcification score encompassing the Adragao score as well as calcifications detected by X-ray of the fistula arm, echocardiography of heart valves and carotid ultrasound.


RESULTS
Using multivariate analysis, age, male gender, dialysis vintage, lower Kt/V, calcium-phosphate product, smoking and high-sensitivity CRP were independent risk factors for cardiovascular calcifications as assessed by the Adragao or the composite score. Pulse wave velocity was independently related to both calcification scores. Body mass index, cholesterol, triglycerides, iPTH and serum levels of fetuin-A and uncarboxylated matrix Gla protein were not associated with cardiovascular calcifications.


CONCLUSIONS
In our cohort of non-diabetic Caucasian haemodialysis patients, age, male gender, dialysis vintage, smoking, calcium-phosphate product, high-sensitivity CRP and lower Kt/V were independent risk factors for cardiovascular calcifications. Whether lowering the calcium-phosphate product and increasing dialysis efficiency can reduce cardiovascular calcifications in dialysis patients remains to be determined.
Schlieper
Georg
G
Department of Nephrology, University Hospital Aachen, Aachen, Germany. gschlieper@ukaachen.de
Brandenburg
Vincent
V
Djuric
Zivka
Z
Damjanovic
Tatjana
T
Markovic
Natasa
N
Schurgers
Leon
L
Kruger
Thilo
T
Westenfeld
Ralf
R
Ackermann
Diana
D
Haselhuhn
Angelika
A
Dimkovic
Sinisa
S
Ketteler
Markus
M
Floege
Jurgen
J
Dimkovic
Nada
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000208:ethnology / Q000209:etiology*; D009202:Cardiomyopathies / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000208:ethnology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D044465:White People