title: Associations between vascular calcification, arterial stiffness and bone mineral density in chronic hemodialysis patients.
abstract: OBJECTIVE
  The aim of our study was to examine the associations between vascular calcification, arterial stiffness and bone mineral density (BMD) in chronic hemodialysis (HD) patients.
  
  
  METHODS
  The study subjects were 83 (70 men and 13 women) HD patients. All patients had computed tomography (CT) to determine aortic calcification index (ACI), pulse wave velocity (PWV) using a volume-plethysmographic apparatus, and BMD estimated by digital image processing (DIP).
  
  
  RESULTS
  Patients, 84.3% male, 38.6% diabetic, had a mean age of 59.3 +/- 11.2 years. In univariate linear regression analysis, ACI correlated positively with age (r = 0.586, P < 0.0001), dialysis vintage (r = 0.47, P = 0.002), pulse pressure (r = 0.311, P = 0.004), C-reactive protein (CRP) (r = 0.226, P = 0.0397) and PWV (r = 0.422, P < 0.0001). There was no significant association between ACI and serum markers of mineral metabolism. There was also a positive association between PWV and systolic blood pressure (P = 0.0004) or pulse pressure (P < 0.0001), and a trend towards greater PWV with increasing age (r = 0.494). In multivariate regression analysis only increasing age, pulse pressure, serum levels of albumin and CRP were significantly associated with ACI and PWV. Mean BMD on DIP was 2.7 +/- 0.4 mmAL. ACI was inversely correlated with BMD (r = -0.234, P = 0.0331).
  
  
  CONCLUSIONS
  Vascular calcification is closely associated with arterial stiffness in HD patients. BMD is inversely correlated with ACI, suggesting that measurement of hand BMD by DIP is a useful tool for assessment of renal bone disease in these patients.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Aoki
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kojima
authors.forename: Keiko
authors.initials: K
authors.lastname: Uchida
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000368:Aged; D015519:Bone Density; D002114:Calcinosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014652:Vascular Diseases / Q000209:etiology*