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Coronary artery calcification, systemic inflammation markers and mineral metabolism in a peritoneal dialysis
Adriano Luiz Ammirati1, Maria Aparecida Dalboni, Miguel Cendoroglo
1Nephrology Division, Federal University of São Paulo, São Paulo, Brazil.
Insights
Coronary artery calcification (CAC) is common in peritoneal dialysis (PD) patients. Inflammation and mineral metabolism issues are linked to CAC development in PD patients.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Peritoneal dialysis (PD) is a renal replacement therapy.
- Cardiovascular disease is a major complication in PD patients.
- Coronary artery calcification (CAC) is a marker of atherosclerosis.
Purpose of the Study:
- To determine the prevalence of CAC in PD patients.
- To investigate the association between comorbidities and CAC development in PD patients.
Main Methods:
- 49 PD patients underwent multislice computed tomography.
- Assessed inflammatory markers, lipid profiles, and calcium-phosphate balance.
- Analyzed anti-oxidized LDL antibody levels.
Main Results:
- 59.2% of PD patients had CAC.
- CAC was associated with older age, hypertension, lower HDL, higher osteoprotegerin, and oxidized LDL.
- Independent predictors of CAC were age and antihypertensive drug use.
Conclusions:
- CAC is highly prevalent in PD patients.
- Inflammation and mineral metabolism disturbances are associated with CAC in PD patients.
Aims:
To assess the prevalence of coronary artery calcification (CAC) in peritoneal dialysis (PD) patients and to determine whether comorbidities such as inflammation, dyslipidemia and mineral metabolism disorders correlate with its development.
Methods:
Forty-nine PD patients (45% male; median age, 52 years) were submitted to multislice computed tomography. Inflammatory markers, anti-oxidized LDL antibody, calcium-phosphate balance and lipid profiles were assessed.
Results:
Twenty-nine patients (59.2%) presented CAC (median calcium score, 234.7 Agatston units). Patients with CAC were older than those without, more frequently presented a history of coronary artery disease or hypertension and had lower HDL cholesterol levels, as well as presenting higher levels of osteoprotegerin and LDL oxidation. The logistic regression revealed that the independent determinants of CAC were age (odds ratio = 1.12; p = 0.006) and number of prescribed anti-hypertensive drugs (odds ratio = 2.38; p = 0.048). When the population was stratified by calcium score quartile, soluble Fas levels were significantly higher in patients with severe calcification. In patients younger than 45, CAC correlated positively with phosphorus levels (r = 0.52; p = 0.04).
Conclusion:
In PD patients, CAC is highly prevalent. Our results indicate that conditions such as inflammation and mineral disturbances are associated with its development.
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