Related Experiment Video
Updated: May 10, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Abdominal aortic calcification is not superior over other vascular calcification in predicting mortality in
Insights
Vascular calcification (VC) in dialysis patients is common. While abdominal aortic calcification is prevalent, VC in the abdomen and pelvis together, or across all evaluated areas, more strongly predicts mortality risk than abdominal VC alone.
Area of Science:
- Nephrology
- Radiology
- Cardiovascular Medicine
Background:
- KDIGO guidelines suggest lateral abdominal radiographs for vascular calcification (VC) assessment in dialysis patients.
- Abdominal aortic calcification is common, but the predictive value of VC in other anatomical areas for mortality is unclear.
Purpose of the Study:
- To evaluate the correlation between VC in different anatomical areas (abdomen, pelvis, hands) and all-cause or cardiovascular mortality in maintenance hemodialysis patients.
Main Methods:
- 217 maintenance hemodialysis patients underwent abdominal, pelvic, and hand radiographs to assess VC.
- Univariate and multivariate models analyzed the association between VC locations and mortality outcomes.
Main Results:
- VC prevalence was 70%, with 90.1% having abdominal aortic calcification.
- VC in the abdomen and pelvis, or across all radiographs, was significantly associated with increased all-cause mortality.
- VC in all evaluated radiographs showed a >6-fold increased risk of all-cause mortality and a >5-fold risk of cardiovascular mortality.
Conclusions:
- VC in different arterial locations is associated with varying mortality risks.
- Lateral abdominal radiographs may not be superior for predicting patient outcomes compared to other areas.
- Further research is needed to understand the impact of diverse VC burdens on patient outcomes.
Background:
KDIGO (Kidney Disease: Improving Global Outcomes) guidelines recommend that a lateral abdominal radiograph should be performed to assess vascular calcification (VC) in dialysis patients. However, abdominal aortic calcification is a prevalent finding, and it remains unclear whether other anatomical areas of VC can predict mortality more accurately.
Methods:
A total of 217 maintenance hemodialysis patients were enrolled at the Sichuan Provincial People's Hospital between July 2010 and March 2011. Radiographs of the abdomen, pelvis and hands were evaluated by a radiologist to evaluate the presence of VC. The correlation between different areas of VC and all-cause or cardiovascular mortality was analyzed using univariate and multivariate models.
Results:
The prevalence of VC was 70.0% (152 patients), and most had abdominal aortic calcification (90.1%). During 26 ± 7 months of follow-up, 37 patients died. The VC score was independently associated with patient mortality. VC observed on abdominal radiographs (abdominal aortic calcification) was associated with all-cause mortality in models adjusted for cardiovascular risk factors (HR, 4.69; 95%CI, 1.60-13.69) and dialysis factors (HR, 3.38; 95%CI, 1.18-9.69). VC in the pelvis or hands was associated with all-cause mortality in the model adjusted for dialysis factors. When three combinations of VC in different radiographs were included in models, the presence of abdominal VC was only significantly associated with all-cause mortality in the integrated model. VC in the abdomen and pelvis was associated with all-cause mortality in the model adjusted for cardiovascular factors and the integrated model, but neither was significantly associated with cardiovascular mortality. VC in all radiographs was significantly associated with a more than 6-fold risk of all-cause mortality and a more than 5-fold risk of cardiovascular mortality compared to patients without VC.
Conclusions:
VC in different arteries as shown on radiographs is associated with different levels of risk for mortality. The lateral abdominal radiograph may not be superior to other radiographs for predicting patient outcomes. Further research is needed to elucidate the effects of difference burdens of VC on patient outcomes.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:25Hemodialysis I: Introduction
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...