Vascular calcifications and renal osteodystrophy in chronic hemodialysis patients: what is the relationship between them?
BACKGROUND
Vascular calcifications (VCs) and renal osteodystrophy (ROD) are frequently seen together and represent the major causes of morbidity and mortality in hemodialysis (HD) patients. Some studies suggest a pathogenic link between them, but there is no consensus as yet regarding this issue. The main objective of our study was to establish whether there is any relation between VCs and ROD in our HD patients. We evaluated the prevalence of VCs and ROD and the relationship between VCs and some clinical and biochemical characteristics of HD patients.


METHODS
We examined radiological signs of VCs and ROD on hands and pelvis bone radiographs in 81 chronic HD patients, and we calculated a VC score on this basis.


RESULTS
We found a significant relation between radiological signs of ROD and those of VC (P = 0.019). The patients with ROD had a higher mean VC score (P = 0.02). By linear regression, the VC score correlated directly with serum calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH) and CaxP product and inversely with serum albumin. The logistic regression model revealed that ROD, male gender and treatment with calcium salts were predictive of VCs development. There were no associations between VCs and age, HD vintage, diabetes, dialysate Ca concentration, vitamin D treatment, spKt/V, URR and C-reactive protein (CRP) levels.


CONCLUSIONS
There seems to be a pathogenetic link between bone and artery diseases in chronic HD patients. Both VCs and ROD have a high prevalence. ROD, male gender and treatment with calcium salts are risk factors for VCs.
Moldovan
Diana
D
Mihai Manasia Nephrology and Dialysis Clinic Cluj-Napoca, University of Medicine and Pharmacy Cluj-Napoca, Nephrology Clinic 3-5 Clinics Street, 400006 Cluj-Napoca, Romania. Diana.Moldovan@umfcluj.ro
Moldovan
Ioan
I
Rusu
Crina
C
Racasan
Simona
S
Patiu
Ioan M
IM
Brumboiu
Adrian
A
Bondor
Cosmina
C
Parvu
Liliana
L
Kacso
Ina
I
Orasan
Remus
R
Gherman-Caprioara
Mirela
M
D000085:Acetates / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D017610:Calcium Compounds / Q000009:adverse effects / Q000627:therapeutic use; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011859:Radiography; D006435:Renal Dialysis; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012737:Sex Factors; D061205:Vascular Calcification / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging*
D000085:Acetates; D050071:Bone Density Conservation Agents; D017610:Calcium Compounds; D010281:Parathyroid Hormone; D012709:Serum Albumin; D010758:Phosphorus; D002119:Calcium Carbonate; D002118:Calcium; C120662:calcium acetate