Prevalence of and Predictive Factor for Abdominal Aortic Calcification in Thai Chronic Kidney Disease Patients

Area of Science:

• Nephrology
• Cardiology
• Radiology

Background:

• Cardiovascular calcifications are significant predictors of morbidity and mortality in chronic kidney disease (CKD).
• Abdominal aortic calcification (AAC) is a key indicator of vascular calcification in CKD patients.
• Understanding AAC prevalence and predictors is crucial for managing cardiovascular risk in CKD.

Purpose of the Study:

• To determine the prevalence of abdominal aortic calcification (AAC) in Thai patients with CKD stages 3-5D.
• To identify predictive factors for AAC in both non-dialysis and dialysis CKD patients.
• To evaluate AAC prevalence and predictors specifically within a subgroup of CKD patients with diabetes.

Main Methods:

• A multicenter, cross-sectional study involving 1500 CKD patients (stages 3-5D) across 24 centers in Thailand.
• Abdominal aortic calcification (AAC) was detected using plain lateral abdominal radiography.
• Statistical analysis, including regression, was performed to identify predictive factors for AAC and assess their significance.

Main Results:

• The prevalence of AAC was high, at 70.6% in non-dialysis and 70.8% in dialysis patients.
• Predictive factors for AAC included advanced age and widening pulse pressure (non-dialysis), and age, comorbidities, dialysis vintage, serum calcium, and hs-CRP (dialysis).
• In the diabetes subgroup (n=692), AAC prevalence was 84.7%, with increased phosphorus as a predictor and 1,25(OH)2 vitamin D as a protective factor.

Conclusions:

• Abdominal aortic calcification (AAC) is highly prevalent in the Thai CKD population, though potentially lower than reported elsewhere.
• Specific patient characteristics and biochemical markers are associated with AAC, offering targets for intervention.
• The high burden of AAC in CKD patients with diabetes underscores the need for focused cardiovascular risk management in this population.