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Updated: Nov 5, 2025

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
08:43

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

Published on: May 31, 2016

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Atherosclerosis-calcification score and predictors of intra-dialytic hypotension

Yaser Aly Ammar

    Clinical Nephrology
    |May 17, 2021
    PubMed

    Insights

    Intra-dialytic hypotension episodes (ID-Hypos) in hemodialysis patients are predicted by high ultrafiltration rate, a novel combined atherosclerosis-calcification score (CACS), and anemia. CACS quantifies vascular pathology, identifying high-risk patients for preventive measures.

    Area of Science:

    • Nephrology
    • Cardiovascular Medicine
    • Vascular Biology

    Background:

    • Intra-dialytic hypotension episodes (ID-Hypos) reduce dialysis efficiency and increase cardiovascular risk in maintenance hemodialysis (MHD) patients.
    • Atherosclerosis and vascular calcification are accelerated in MHD patients, contributing to cardiovascular complications.

    Purpose of the Study:

    • To investigate predictors of ID-Hypos, focusing on a novel combined atherosclerosis-calcification score (CACS).
    • To assess the correlation of CACS, derived from atherosclerosis score (AS) and abdominal aortic calcification score (AACS), with ID-Hypos.

    Main Methods:

    • AS was determined using ankle-brachial index and carotid ultrasound.
    • AACS was modified from the Kauppila score on abdominal radiographs.
    • ID-Hypos were recorded over 14 weeks in 60 MHD patients and correlated with CACS, ultrafiltration rate (UFR), and other parameters.

    Main Results:

    • The number of ID-Hypos positively correlated with CACS (r=0.291, p=0.024).
    • Multivariate analysis identified high UFR, high CACS, and low hemoglobin as significant independent predictors of ID-Hypos.
    • Serum C-reactive protein showed an initial correlation with ID-Hypos, which was not significant in adjusted models.

    Conclusions:

    • High UFR, CACS, and anemia are significant predictors of ID-Hypos in MHD patients.
    • CACS can quantify vascular pathology and identify patients at high risk for ID-Hypos.
    • Chronic inflammation may link patient-related ID-Hypos risk factors.
    Abstract

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