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Intraoperative Arterial Biopsy in Incident Hemodialysis Patients: Differences Observed

Ahmed Fayed1, Ahmed Soliman2, Hossam El Mahdy3

  • 1Nephrology Unit, Department of Internal Medicine, School of Medicine, Cairo University, Cairo, Egypt, dr.fayed@gmail.com.

Nephron
|June 7, 2019
PubMed

Insights

Half of chronic kidney disease (CKD) patients undergoing hemodialysis have arterial calcification, primarily in the tunica media. Serum phosphorus levels significantly impact the intensity of this arterial calcification.

Area of Science:

  • Nephrology
  • Vascular Biology
  • Pathology

Background:

  • Arterial calcification (AC) is a frequent complication in chronic kidney disease (CKD) patients, often developing before end-stage renal disease.
  • Calcification can affect the tunica intima or tunica media of arteries in CKD patients.

Purpose of the Study:

  • To investigate the prevalence, severity, and distribution of arterial wall calcification in incident hemodialysis patients.
  • To correlate arterial calcification with various serum biochemical markers.

Main Methods:

  • Intraoperative arterial biopsy during arteriovenous access creation in 172 stage 5 CKD adults.
  • Histopathological examination of arterial samples.
  • Analysis of serum calcium, phosphorus, alkaline phosphatase, uric acid, parathormone (PTH), FGF23, and 25 hydroxy vitamin D.

Main Results:

  • 50% of patients exhibited arterial calcification (AC), with 21% showing both intimal and medial involvement.
  • Significantly higher serum PTH levels were observed in patients with AC.
  • Serum phosphorus, calcium x phosphorus product, PTH, and FGF23 showed significant differences based on calcification intensity.

Conclusions:

  • Half of incident hemodialysis CKD patients develop arterial calcification, predominantly in the tunica media.
  • Serum phosphorus levels play a role in determining the intensity of arterial calcification.
Abstract

Keywords:
Arterial biopsyChronic kidney diseaseVascular calcification

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