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Updated: Jul 15, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
The progression and impact of vascular calcification in peritoneal dialysis patients
Adriano Luiz Ammirati1, Maria Aparecida Dalboni, Miguel Cendoroglo
1Nephrology Division, Federal University of São Paulo, 282 Pedro de Toledo Street, São Paulo 04039-000, Brazil.
Insights
In peritoneal dialysis patients, baseline coronary artery calcification (CAC) predicts progression and cardiovascular events. Metabolic factors like glucose and lipid levels also indicate higher CAC progression risk.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Coronary artery calcification (CAC) progression is known in hemodialysis patients.
- Severe CAC is linked to cardiovascular events in hemodialysis patients.
- Limited data exists on CAC progression in peritoneal dialysis (PD) patients.
Purpose of the Study:
- To prospectively assess PD patients for variables associated with CAC progression.
- To determine the impact of baseline CAC on clinical outcomes over one year.
- To identify risk factors for CAC progression in PD patients.
Main Methods:
- 49 PD patients underwent coronary tomography for calcium scoring at baseline and 12 months.
- Clinical characteristics and biochemical variables (lipids, mineral metabolism, inflammation) were compared.
- Cardiovascular events, hospitalizations, and mortality were recorded.
Main Results:
- 59% of patients had baseline CAC (median score 234.7 AU).
- CAC progression occurred in 43% of patients, associated with older age, higher baseline CAC, higher glucose, lower HDL, and longer use of low-calcium PD solution.
- Baseline CAC was the only independent predictor of CAC progression; baseline CAC was associated with shorter cardiovascular event-free time.
Conclusions:
- Coronary artery calcification (CAC) assessment offers crucial prognostic information in peritoneal dialysis (PD) patients.
- Elevated baseline CAC, glucose, mineral, and lipid metabolism disturbances are associated with increased risk of CAC progression in PD patients.
Background:
Progression of coronary artery calcification (CAC) has been described in hemodialysis patients, and severe CAC has been associated with the occurrence of cardiovascular events in this population. Little information is available regarding peritoneal patients.
Aim:
To prospectively evaluate peritoneal dialysis patients in order to identify the variables associated with the rate of CAC progression, as well as to determine the impact that baseline CAC has on clinical outcomes over a 1-year follow-up period.
Methods:
Using multislice coronary tomography, calcium scores were estimated at baseline and after 12 months in 49 peritoneal dialysis patients. Patients with and without CAC progression were compared with respect to clinical characteristics and biochemical variables, including lipid profile, parameters of mineral metabolism, and markers of inflammation. Cardiovascular events, hospitalizations, and all-cause mortality were recorded.
Results:
At baseline, 29 patients (59%) presented CAC and a median calcium score of 234.7 (range 10.3-2351) Agatston units. Progression of CAC was observed in 13 patients (43%) who, in comparison with those presenting no CAC progression, were older, presented higher baseline calcium scores, and had higher mean glucose levels, lower mean high density lipoprotein cholesterol levels, and more months using low calcium peritoneal solution. We also observed a trend toward more often presenting with a history of hypertension, exhibiting more hyperphosphatemic and hyperglycemic events, and having lower albumin levels. In multiple logistic regression, only baseline calcium score was independently associated with progression of CAC. A shorter cardiovascular event-free time and a trend toward lower survival rates were observed in the group with CAC. Hospitalization event-free time did not differ between the groups.
Conclusion:
Determining CAC provides important prognostic data in peritoneal dialysis patients. Baseline calcium score and disturbances in glucose, mineral, and lipid metabolism were indicative of higher risk of CAC progression in this population.
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