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Prevalence and risk factors for vascular calcification in Chinese patients receiving dialysis: baseline results from
Zhi-Hong Liu1, Xue-Qing Yu2, Jun-Wei Yang3
1a Department of Nephrology , National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine , Nanjing , PR China.
Insights
Vascular calcification is highly prevalent in Chinese chronic kidney disease (CKD) patients undergoing dialysis. This study highlights the need for increased awareness and optimized management strategies for vascular calcification (VC) in this population.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Limited data exists on vascular calcification (VC) prevalence in Chinese chronic kidney disease (CKD) patients on dialysis.
- VC is a significant complication in CKD patients, associated with increased cardiovascular risk.
Purpose of the Study:
- To determine the prevalence of vascular/valvular calcification (VC) in Chinese patients undergoing hemodialysis (HD) or peritoneal dialysis (PD).
- To investigate the association of risk factors with VC in this population.
Main Methods:
- The China Dialysis Calcification Study (CDCS) enrolled 1,497 CKD patients on HD/PD for ≥6 months.
- Calcification was assessed using computed tomography (CT) for coronary artery calcification (CAC), radiography for abdominal aortic calcification (AAC), and echocardiography for cardiac valvular calcification (ValvC).
- Serum levels of phosphorus, calcium, intact parathyroid hormone (iPTH), 25-hydroxyvitamin D, and FGF-23 were measured. Logistic regression analyzed risk factor associations.
Main Results:
- A high prevalence of VC was observed: 77.4% in the final analysis cohort (n=1,493) and 77.5% in the baseline complete data cohort (n=1,423).
- Prevalence was higher in hemodialysis (HD) patients (80.8%) compared to peritoneal dialysis (PD) patients (65.1%).
- Single-site calcification was observed in 20% (CAC), 4.3% (AAC), and 4.3% (ValvC). Calcification at multiple sites was common, with 17.9% having calcification at all three assessed locations.
Conclusions:
- The study reveals a high prevalence of vascular/valvular calcification (VC) in Chinese CKD patients on dialysis.
- These findings contribute crucial data to the limited existing knowledge on VC in this demographic.
- Increased awareness and optimized management strategies for VC are recommended for Chinese CKD patients.
Objective:
With limited data available on calcification prevalence in chronic kidney disease (CKD) patients on dialysis, the China Dialysis Calcification Study (CDCS) determined the prevalence of vascular/valvular calcification (VC) and association of risk factors in Chinese patients with prevalent hemodialysis (HD) or peritoneal dialysis (PD).
Methods:
CKD patients undergoing HD/PD for ≥6 months were enrolled. Prevalence data for calcification and medical history were documented at baseline. Coronary artery calcification (CAC) was assessed by electron beam or multi-slice computed tomography (EBCT/MSCT), abdominal aortic calcification (AAC) by lateral lumbar radiography, and cardiac valvular calcification (ValvC) by echocardiography. Serum phosphorus, calcium, intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D and FGF-23 were evaluated. A logistic regression model was used to evaluate the association between risk factors and VC.
Results:
Of 1,497 patients, 1,493 (78.3% HD, 21.7% PD) had ≥1 baseline calcification image (final analysis cohort, FAC) and 1,423 (78.8% HD, 21.2% PD) had baseline calcification data complete (BCDC). Prevalence of VC was 77.4% in FAC (80.8% HD, 65.1% PD, p < .001) and 77.5% in BCDC (80.7% HD, 65.8% PD). The proportion of BCDC patients with single-site calcification were 20% for CAC, 4.3% for AAC, and 4.3% for cardiac valvular calcification (ValvC), respectively. Double site calcifications were 23.4% for CAC and AAC, 6.5% for CAC and ValvC, and 1.1% for AAC and ValvC, respectively. In total, 17.9% patients had calcification at all three sites.
Conclusions:
High prevalence of total VC in Chinese CKD patients will supplement current knowledge, which is mostly limited, contributing in creating awareness and optimizing VC management.
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