Risk factors for abdominal aortic calcifications in chronic hemodialysis patients

Abstract

Introduction: Cardiovascular disease represents the leading cause of death in chronic hemodialysis (HD) patients; in this field, abdominal aortic calcifications (AAC) which represent a predictor of cardiovascular events are associated with cardiovascular morbidity and mortality. Objectives: The purpose of our study is to determine the prevalence and factors associated with AAC. Patients and Methods: This cross-sectional study including 40 chronic HD patients for more than six months having benefited from screening for AAC by profile abdominal x-ray without preparation. The AAC were evaluated according to the Kauppila score (ScK). Demographic, biological and radiological data were collected and then analyzed to assess the prevalence of AAC. Patients were divided into two groups according to ScK, highly calcified (ScK ≥12) and slightly or moderately calcified (ScK <12), in order to determine the associated factors to severe AAC. Results: The mean age was 58 ± 16 years, 55% were women, and the median of HD duration is 82 months. The prevalence of AAC was 65% and the median score of AAC was four. Patients with highly AAC (ScK ≥12) represented 27.5% of population and slightly or moderately AAC (ScK <12) represented 72.5%. The factors associated with severe AAC retained in the univariate analysis were age (P=0.029), phosphoremia (P=0.027), duration of dialysis (P=0.047) and calcemia (P=0.035). Only duration of dialysis (P=0.042), age (P=0.018) and phosphoremia (P=0.044) remained statistically significant in multivariate. Conclusion: AAC are associated with advanced age, long duration of dialysis, and phosphocalcic balance abnormalities. Profile abdominal x-ray without preparation is currently recommended by the KDIGO (kidney disease improving global outcomes) for early detection and follow-up of vascular calcifications on HD, which should be considered for any patient.