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

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 a...

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Published in:Therapeutic advances in chronic disease 2015-05, Vol.6 (3), p.84-96
Main Authors: Kraus, Mark A., Kalra, Philip A., Hunter, John, Menoyo, José, Stankus, Nicole
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creator Kraus, Mark A.
Kalra, Philip A.
Hunter, John
Menoyo, José
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description 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 
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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 &lt; 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 &lt; 0.0001). Moderate/severe aortic valve calcification was significantly more prevalent in patients aged ⩾65 years than &lt;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.</description><identifier>ISSN: 2040-6223</identifier><identifier>EISSN: 2040-6231</identifier><identifier>DOI: 10.1177/2040622315578654</identifier><identifier>PMID: 25984289</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Original Research</subject><ispartof>Therapeutic advances in chronic disease, 2015-05, Vol.6 (3), p.84-96</ispartof><rights>The Author(s), 2015</rights><rights>The Author(s), 2015 2015 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-a35d15e9ada1e663383e6bf1801411de06e357136dbe6873f8c46856fefa3e7d3</citedby><cites>FETCH-LOGICAL-c467t-a35d15e9ada1e663383e6bf1801411de06e357136dbe6873f8c46856fefa3e7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416967/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416967/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,21947,27834,27905,27906,44926,45314,53772,53774</link.rule.ids><linktorsrc>$$Uhttps://journals.sagepub.com/doi/full/10.1177/2040622315578654?utm_source=summon&amp;utm_medium=discovery-provider$$EView_record_in_SAGE_Publications$$FView_record_in_$$GSAGE_Publications</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25984289$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kraus, Mark A.</creatorcontrib><creatorcontrib>Kalra, Philip A.</creatorcontrib><creatorcontrib>Hunter, John</creatorcontrib><creatorcontrib>Menoyo, José</creatorcontrib><creatorcontrib>Stankus, Nicole</creatorcontrib><title>The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study</title><title>Therapeutic advances in chronic disease</title><addtitle>Ther Adv Chronic Dis</addtitle><description>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 &lt; 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 &lt; 0.0001). Moderate/severe aortic valve calcification was significantly more prevalent in patients aged ⩾65 years than &lt;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. 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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 &lt; 0.0001) and mitral annulus (p = 0.0001) but not mitral valve. 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title The prevalence of vascular calcification in patients with end-stage renal disease on hemodialysis: a cross-sectional observational study
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