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Kraus MA, Kalra PA, Hunter J, et al. The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study. Ther Adv Chronic Dis. 2015;6(3):84-96doi: 10.1177/2040622315578654.
Kraus, M. A., Kalra, P. A., Hunter, J., Menoyo, J., & Stankus, N. (2015). The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study. Therapeutic advances in chronic disease, 6(3), 84-96. https://doi.org/10.1177/2040622315578654
Kraus, Mark A, et al. "The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study." Therapeutic advances in chronic disease vol. 6,3 (2015): 84-96. doi: https://doi.org/10.1177/2040622315578654
Kraus MA, Kalra PA, Hunter J, Menoyo J, Stankus N. The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study. Ther Adv Chronic Dis. 2015 May;6(3):84-96. doi: 10.1177/2040622315578654. PMID: 25984289; PMCID: PMC4416967.
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Ther Adv Chronic Dis. 2015 May;6(3):84-96. doi: 10.1177/2040622315578654.

The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study.

Therapeutic advances in chronic disease

Mark A Kraus, Philip A Kalra, John Hunter, José Menoyo, Nicole Stankus

Affiliations

  1. Division of Nephrology and Hypertension, John H. Stroger Jr Hospital of Cook County, 627 South Wood Street, Suite 621, Chicago, IL 60612, USA.
  2. Renal Unit, Salford Royal Foundation Trust, Salford, UK.
  3. Formerly of Biostatistics, Sanofi, Cambridge, MA, USA.
  4. Formerly of Renal Global Medical Affairs, Sanofi, Cambridge, MA, USA.
  5. Section of Nephrology, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.

PMID: 25984289 PMCID: PMC4416967 DOI: 10.1177/2040622315578654

Abstract

BACKGROUND: This multicenter international cross-sectional observational study characterized vascular and valvular calcification burden and correlations with pulse pressure, diabetes, hypertension, and cardiovascular diseases in prevalent hemodialysis patients.

METHODS: We enrolled 275 consecutive adults with end-stage renal disease on maintenance hemodialysis for ⩾3 months. Coprimary endpoints were prevalences of: (1) echocardiographic calcification in mitral valve, aortic valve or mitral annulus; (2) aortoiliac tree vascular calcifications by plain lateral lumbar X-ray. Correlations among calcification sites and with demographics and comorbidities were determined. Pulse pressures were determined.

RESULTS: Subjects' mean ± standard deviation (SD) age was 56 ± 15.9 years; mean (SD) dialysis duration was 4.5 ± 4.3 years. Overall, 100% of echocardiographically imaged patients (n = 243) had calcification in aortic valve, mitral valve, or mitral annulus; 77.8% of X-rayed patients (n = 248) had abdominal aortic calcification. Radiographic abdominal aortic calcification score correlated significantly with calcification of aortic valve (p < 0.0001) and mitral annulus (p = 0.0001) but not mitral valve. Aortic valve, mitral valve, and mitral annulus calcification correlated significantly among themselves (p < 0.0001). Moderate/severe aortic valve calcification was significantly more prevalent in patients aged ⩾65 years than <65 years, men than women, and Whites than African Americans. Pulse pressure correlated significantly with vascular calcification score (p = 0.0049) but not with valvular calcification at any site.

CONCLUSIONS: Vascular and valvular calcification are highly prevalent in the hemodialysis population. Peripheral vascular calcification correlates significantly with elevated pulse pressure and can be assessed easily using lateral lumbar X-ray. Further studies investigating the interaction between pulse pressure and development or progression of vascular calcification are of interest.

Keywords: chronic kidney disease; echocardiography; hemodialysis; lumbar X-ray; valvular calcification; vascular calcification

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