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Coronary artery calcification in Korean patients with incident dialysis

Eunjin Bae1, Eun Yong Seong2, Byoung-Geun Han3

  • 1Department of Internal Medicine, Gyeongsang National University College of Medicine, Changwon, Korea.

Hemodialysis International. International Symposium on Home Hemodialysis
|October 7, 2016
PubMed

Insights

Coronary artery calcification (CAC) is common in patients starting dialysis for end-stage renal disease (ESRD). Higher age is the primary risk factor for CAC in this population, and L-spine radiography may aid diagnosis.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Patients with chronic kidney disease (CKD) face a high risk of cardiovascular disease (CVD).
  • Coronary artery calcification (CAC) in end-stage renal disease (ESRD) patients correlates with increased CVD mortality.
  • Identifying CAC risk factors in incident dialysis patients is crucial for risk stratification.

Purpose of the Study:

  • To determine the risk factors for coronary artery calcification (CAC) in Korean patients initiating dialysis.
  • To evaluate the diagnostic utility of L-spine radiography for CAC in this cohort.

Main Methods:

  • A cohort of 423 incident dialysis patients from 10 university hospitals was analyzed.
  • Coronary artery calcification (CAC) was assessed using cardiac multidetector computed tomography (MDCT) and quantified by Agatston score.
  • Risk factors were analyzed using univariate and multiple regression analyses; L-spine radiography performance was evaluated via ROC curves.

Main Results:

  • The prevalence of CAC (Agatston score >0) was 63.8% in incident dialysis patients.
  • While univariate analysis revealed associations with age, sex, ESRD etiology, and comorbidities, only higher age significantly predicted CAC in multiple regression.
  • L-spine radiography demonstrated a sensitivity of 56% and specificity of 91% for diagnosing CAC (AUC=0.735).

Conclusions:

  • Coronary artery calcification is highly prevalent in patients starting dialysis.
  • Advanced age is the primary independent risk factor for CAC in this population.
  • L-spine radiography may serve as a practical screening tool for detecting CAC in incident dialysis patients.
Abstract

Keywords:
Cardiovascular diseaseL-spine radiographycoronary artery calcificationend-stage renal disease

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