title: Determinants of coronary artery calcification in maintenance hemodialysis patients.
abstract: In addition to the well-known traditional risk factors, uremia-related so-called novel risk factors and medications appear to affect coronary artery calcification in hemodialysis patients. This study was performed to evaluate coronary artery calcification score (CACS) in maintenance hemodialysis (MHD) patients, and to identify significantly related factors. We assessed CACS using Agatston Score by MDCT, sex, age, dialysis vintage, presence of diabetes mellitus, smoking history, presence of ≥100 ml urine volume/day, normalized protein catabolic rate, geriatric nutritional risk index, administration of active vitamin D3, cinacalcet, phosphate binders or antihypertensive agents, and circulation parameters including creatinine, albumin, corrected calcium and phosphate in 207 MHD patients. Coronary artery calcifications were observed in 192 patients (92.8%). In multivariate analysis, CACS showed direct associations with age (p < 0.001), dialysis vintage (p < 0.001) and presence of diabetes mellitus (p < 0.01), and an inverse association only with active vitamin D3 administration (p < 0.001) in MHD patients. Patients with active vitamin D3 showed significantly lower CACS than in those without it (1349.6 ± 1635.0 vs. 2475.6 ± 2646.6 H, p < 0.05). Older age, longer duration of dialysis and diabetes mellitus are risk factors and administration of active vitamin D3 is protective factor for coronary artery calcification in MHD patients.
authors: Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, y-nishizawa@icy.or.jp.
authors: Yoshiko
authors: Y
authors: Nishizawa
authors: Sonoo
authors: S
authors: Mizuiri
authors: Noriaki
authors: N
authors: Yorioka
authors: Chieko
authors: C
authors: Hamada
authors: Yasuhiko
authors: Y
authors: Tomino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium; D002120:Calcium Channel Agonists / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D061205:Vascular Calcification / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D002120:Calcium Channel Agonists; D002117:Calcitriol; D002118:Calcium