Qingyu Niu1, Huiping Zhao2, Bei Wu1, Shihming Tsai1, Jian Wu3, Meng Zhang3, Lixia Lu1, Jie Qiao1, Chuncui Men1, Li Zuo1, Mei Wang1. 1. Department of Nephrology, Peking University People's Hospital, Beijing, China. 2. Department of Nephrology, Peking University People's Hospital, Beijing, China, huipingzhao2009@163.com. 3. Department of Radiology, Peking University People's Hospital, Beijing, China.
Abstract
OBJECTIVE: To investigate the occurrence of vascular calcification (VC) in different types of arteries in patients with maintenance peritoneal dialysis (PD) patients and its influencing factors. METHODS: This study enrolled PD patients with stable status who has received PD treatment for more than 6 months in Peking University People's Hospital. We used plain X-ray films of abdomen, pelvis, and hands to quantitatively evaluate VC of large artery (abdominal aorta, iliac artery), medium artery (femoral artery, radial artery), and small artery (finger arteries). Two radiologists read and scored radiographs blindly. Demographic data, clinical characteristics, Charlson comorbidity index (CCI), baseline and time-average laboratory indices including parameters of calcium phosphorus metabolism, serum albumin, PD adequacy were collected. A logistic regression model was used to estimate the influencing factors of different sites of VC. RESULTS: (1) 154 PD patients were enrolled in this study: seventy-eight males, mean age was 60.4 ± 13.9 years, and median PD duration was 24 (16.39) months. The major primary disease was diabetic nephropathy (39%). (2) Among the 154 PD patients, the proportion of calcification of large artery was the highest (found in 100 patients, accounting for 64.9%); then the medium artery (66, 42.9%); and 15 of small artery, accounting for 9.7%. (3) Logistic regression showed that older age, longer dialysis duration, lower baseline serum intact parathyroid hormone (iPTH), and higher CCI scores were independent risk factors of large artery calcification (p < 0.05), and higher CCI scores, higher baseline serum triglycerides (TG), lower baseline serum iPTH, and time-average iPTH were independent risk factors of medium and small arteries. CONCLUSIONS: In PD patients, the occurrence of large artery calcification was higher than others. Among different sites of VC, the abdominal aortic calcification was most likely to occur, and the proportion of small artery calcification was low. Calcification of medium and small arteries can exist alone without calcification of large artery. Large artery calcification was more likely to occur in patients with older age, longer dialysis duration, lower baseline serum iPTH levels and higher CCI scores. Patients with higher CCI scores, higher baseline TG and lower baseline iPTH, and time-average iPTH were more likely to develop small and medium artery calcification.
OBJECTIVE: To investigate the occurrence of vascular calcification (VC) in different types of arteries in patients with maintenance peritoneal dialysis (PD) patients and its influencing factors. METHODS: This study enrolled PDpatients with stable status who has received PD treatment for more than 6 months in Peking University People's Hospital. We used plain X-ray films of abdomen, pelvis, and hands to quantitatively evaluate VC of large artery (abdominal aorta, iliac artery), medium artery (femoral artery, radial artery), and small artery (finger arteries). Two radiologists read and scored radiographs blindly. Demographic data, clinical characteristics, Charlson comorbidity index (CCI), baseline and time-average laboratory indices including parameters of calcium phosphorus metabolism, serum albumin, PD adequacy were collected. A logistic regression model was used to estimate the influencing factors of different sites of VC. RESULTS: (1) 154 PDpatients were enrolled in this study: seventy-eight males, mean age was 60.4 ± 13.9 years, and median PD duration was 24 (16.39) months. The major primary disease was diabetic nephropathy (39%). (2) Among the 154 PDpatients, the proportion of calcification of large artery was the highest (found in 100 patients, accounting for 64.9%); then the medium artery (66, 42.9%); and 15 of small artery, accounting for 9.7%. (3) Logistic regression showed that older age, longer dialysis duration, lower baseline serum intact parathyroid hormone (iPTH), and higher CCI scores were independent risk factors of large artery calcification (p < 0.05), and higher CCI scores, higher baseline serum triglycerides (TG), lower baseline serum iPTH, and time-average iPTH were independent risk factors of medium and small arteries. CONCLUSIONS: In PDpatients, the occurrence of large artery calcification was higher than others. Among different sites of VC, the abdominal aortic calcification was most likely to occur, and the proportion of small artery calcification was low. Calcification of medium and small arteries can exist alone without calcification of large artery. Large artery calcification was more likely to occur in patients with older age, longer dialysis duration, lower baseline serum iPTH levels and higher CCI scores. Patients with higher CCI scores, higher baseline TG and lower baseline iPTH, and time-average iPTH were more likely to develop small and medium artery calcification.
Authors: Allan J Collins; Robert Foley; Charles Herzog; Blanche Chavers; David Gilbertson; Areef Ishani; Bertram Kasiske; Jiannong Liu; Lih-Wen Mau; Marshall McBean; Anne Murray; Wendy St Peter; Jay Xue; Qiao Fan; Haifeng Guo; Qi Li; Shuling Li; Suying Li; Yi Peng; Yang Qiu; Tricia Roberts; Melissa Skeans; Jon Snyder; Craig Solid; Changchun Wang; Eric Weinhandl; David Zaun; Rui Zhang; Cheryl Arko; Shu-Cheng Chen; Frederick Dalleska; Frank Daniels; Stephan Dunning; James Ebben; Eric Frazier; Christopher Hanzlik; Roger Johnson; Daniel Sheets; Xinyue Wang; Beth Forrest; Edward Constantini; Susan Everson; Paul Eggers; Lawrence Agodoa Journal: Am J Kidney Dis Date: 2008-01 Impact factor: 8.860
Authors: Eero Honkanen; Leena Kauppila; Björn Wikström; Pieter L Rensma; Jean-Marie Krzesinski; Knut Aasarod; Francis Verbeke; Per Bruno Jensen; Pierre Mattelaer; Birgitte Volck Journal: Nephrol Dial Transplant Date: 2008-08-01 Impact factor: 5.992