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[Risk factors for progression of coronary artery calcification over 5 years in hemodialysis patients]

A Alayoud1, M El Amrani2, M Belarbi3

  • 1Service de néphrologie, dialyse, premier centre médico-chirurgical, Agadir, Maroc; Faculté de médecine et pharmacie Ibn Zohr, Agadir, Maroc.

Annales De Cardiologie Et D'Angeiologie
|March 5, 2020
PubMed

Insights

Coronary artery calcification progression in dialysis patients is linked to age, diabetes, and inflammation. Early management of chronic kidney disease is key to slowing this cardiovascular risk factor.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Radiology

Background:

  • Coronary artery calcification (CAC) is a key cardiovascular morbidity marker.
  • Limited research exists on CAC progression in end-stage renal disease (ESRD) patients.
  • This study investigates risk factors for CAC changes in dialysis patients.

Purpose of the Study:

  • To examine and evaluate risk factors associated with changes in coronary artery calcification (CAC) in patients undergoing hemodialysis.
  • To identify predictors of CAC progression in this high-risk population.

Main Methods:

  • Coronary artery calcification (CAC) was assessed using 64 multi-slice ultra-fast CT in 28 hemodialysis (HD) patients.
  • CAC was measured at baseline and after a five-year follow-up.
  • Patients were categorized as progressors or non-progressors based on CAC score changes.

Main Results:

  • Slow CAC progression (21.4%) was observed over an average 63-month follow-up.
  • Progression was significantly associated with older age, diabetes, male sex, hypercholesterolemia, anemia, inflammation, and hyperphosphatemia.
  • Baseline CAC scores strongly predicted 5-year increments, while calcemia, PTH, dialysis duration, tobacco, hypertension, and dialysis dose did not influence progression.

Conclusions:

  • CAC progression in dialysis patients is complex and influenced by multiple risk factors, particularly elevated baseline scores.
  • Effective management strategies, initiated early in chronic kidney disease, may prevent or slow CAC progression.
  • Targeting specific risk factors is crucial for mitigating cardiovascular risk in ESRD patients.
Abstract

Keywords:
AGASTON ScoreCalcifications coronairesCoronary calcificationFacteurs de risqueHemodialysisHémodialyseProgressionRisk factorsScore AGASTON

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