Impaired fasting glucose and diabetes as predictors for radial artery calcification in end stage renal disease patients.
Objective. The objective of the study was to assess the relationship between selected clinical and biochemical parameters of end stage renal disease (ESRD) patients and arterial calcification. Materials and Methods. The study comprised 59 stage 5 chronic kidney disease patients (36 hemodialyzed and 23 predialysis). The examined parameters included common carotid artery intima-media thickness (CCA-IMT), BMI, incidence of diabetes and impaired fasting glucose (IFG), dyslipidemia, hypertension, and 3-year mortality. Plasma levels asymmetric dimethylarginine (ADMA), osteopontin (OPN), osteoprotegerin (OPG), and osteocalcin (OC) were also measured. Fragments of radial artery obtained during creation of hemodialysis access were stained for calcifications using von Kossa method and alizarin red. Results. Calcification of radial artery was significantly associated with higher prevalence of IFG and diabetes (P = 0.0004) and older age (P = 0.003), as well as higher OPG (P = 0.014) and ADMA concentrations (P = 0.022). Fasting glucose >5.6 mmol/l (IFG and diabetes) significantly predicted vascular calcification in multiple logistic regression. The calcification was also associated with higher CCA-IMT (P = 0.006) and mortality (P = 0.004; OR for death 5.39 [1.20-24.1] after adjustment for dialysis status and age). Conclusion. Combination of renal insufficiency and hyperglycemic conditions exerts a synergistic effect on vascular calcification and increases the risk of death.
Chair and Department of Nephrology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Katarzyna
K
Janda
Chair and Department of Nephrology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Marcin
M
Krzanowski
Chair and Department of Histology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Mariusz
M
Gajda
Department of Medical Diagnostics, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Paulina
P
Dumnicka
Chair of Clinical Biochemistry, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Danuta
D
Fedak
Chair and Department of Histology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Grzegorz J
GJ
Lis
Chair and Department of Nephrology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Piotr
P
Jaśkowski
Chair and Department of Histology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Jan A
JA
Litwin
Chair and Department of Nephrology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
Władysław
W
Sułowicz