title: Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients.
abstract: BACKGROUND
  Process of accelerated atherosclerosis specific for uremia increases cardiovascular risk in patients with chronic kidney disease (CKD) and may be influenced by the different structure of arteries. The study assesses the influence of traditional and novel risk factors on calcification of coronary arteries (CAC) and abdominal aorta (AAC) in hemodialysis patients (HD).
  
  
  METHODS
  CAC and AAC were assessed by CT in 104 prevalent adult HD and 14 apparently healthy subjects with normal kidney function (control group). Mineral metabolism parameters, plasma levels of FGF-23, MGP, osteoprotegerin, osteopontin, fetuin-A, CRP, IL-6 and TNF-α were measured.
  
  
  RESULTS
  CAC and AAC (calcification score ≥ 1) were found in 76 (73.1%) and 83 (79.8%) HD respectively, more frequent than in the control group. In 7 HD with AAC no CAC were detected. The frequency and severity of calcifications increased with age. Both CAC and AAC were more frequently detected in diabetics (OR = 17.37 and 13.00, respectively). CAC score was significantly greater in males. CAC and AAC scores were correlated significantly with pack-years of smoking and plasma osteoprotegrin levels. However the independent contribution of plasma osteoprotegerin levels was not confirmed in multiple regression analysis. Age (OR = 1.13) and hemodialysis vintage (OR = 1.14) were the independent risk factor favoring the occurrence of CAC; while age (OR = 1.20) was the only predictor of AAC occurrence in HD.
  
  
  CONCLUSIONS
  1. AAC precedes the occurrence of CAC in HD patients. 2. The exposition to uremic milieu and systemic chronic microinflammation has more deteriorative effect on the CAC than the AAC.
authors: Department of Radiology, Medical University Hospital SPSK-M, Katowice, Poland.
authors: Przemysław
authors: P
authors: Pencak
authors: Beata
authors: B
authors: Czerwieńska
authors: Rafał
authors: R
authors: Ficek
authors: Katarzyna
authors: K
authors: Wyskida
authors: Agata
authors: A
authors: Kujawa-Szewieczek
authors: Magdalena
authors: M
authors: Olszanecka-Glinianowicz
authors: Andrzej
authors: A
authors: Więcek
authors: Jerzy
authors: J
authors: Chudek
mesh_terms: D001012:Aorta, Abdominal; D001021:Aortic Valve / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000453:epidemiology*; D002114:Calcinosis / Q000453:epidemiology*; D015984:Causality; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000534:rehabilitation*; D012307:Risk Factors