Arterial micro-calcification of vascular access is associated with aortic arch calcification and arterial stiffness in hemodialysis patients

Semin Dial. 2013 Mar-Apr;26(2):216-22. doi: 10.1111/j.1525-139X.2012.01113.x. Epub 2012 Aug 22.

Abstract

Vascular calcification of the coronary arteries or aorta is an independent risk factor for cardiovascular outcome, but clinical significance of arterial micro-calcification (AMC) of vascular access is unclear in hemodialysis (HD) patients. Sixty-five patients awaiting vascular access operation were enrolled. We compared surrogate markers of cardiovascular morbidity such as aortic arch calcification (AoAC) by chest radiography, arterial stiffness by brachial-ankle pulse wave velocity (baPWV) and endothelial dysfunction by flow-mediated dilatation (FMD) between patients with and without AMC of vascular access on von Kossa staining. AMC of vascular access was detected in 36 (55.4%). The AMC-positive group had significantly higher incidence of AoAC (63.9% vs. 20.7%, p < 0.001) and higher baPWV (26.5 ± 9.4 m/s vs. 19.8 ± 6.6 m/s, p = 0.006) than the AMC-negative group. There was no significant difference in FMD between the two groups (5.4 ± 2.6% vs. 5.7 ± 3.5%, p = 0.764). The AMC-positive group had higher incidence of diabetes mellitus, higher systolic blood pressure and wider pulse pressure than the AMC-negative group. This study suggests that AMC of vascular access may be associated with cardiovascular morbidity via AoAC and arterial stiffness in HD patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aorta, Thoracic / physiopathology*
  • Aortic Diseases / physiopathology*
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Biomarkers / analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Regression Analysis
  • Renal Dialysis / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Vascular Calcification / physiopathology*
  • Vascular Stiffness*

Substances

  • Biomarkers