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Vascular calcification progression in patients with end-stage chronic kidney disease

Enrique M San Norberto1, Álvaro Revilla2, Ana Fernández-Urbón3

  • 1Department of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain - esannorberto@hotmail.com.

International Angiology : a Journal of the International Union of Angiology
|September 13, 2021
PubMed

Insights

Hemodialysis (HD) significantly increases cardiovascular calcification in end-stage renal disease (ESRD) patients compared to continuous ambulatory peritoneal dialysis (CAPD) or controls. Dialysis type is a key predictor of vascular changes in ESRD.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Intima media thickness (IMT), vascular calcifications, and ankle-brachial pressure index (ABPI) predict mortality in end-stage renal disease (ESRD) patients.
  • Cardiovascular complications are a major concern in ESRD patients.

Purpose of the Study:

  • To investigate the impact of different dialysis modalities on vascular calcification progression in ESRD patients.
  • To identify independent predictors of vascular changes in ESRD.

Main Methods:

  • A prospective, nonrandomized study included 284 ESRD patients (152 dialysis, 132 controls) from January 2018 to March 2019.
  • Carotid IMT, vascular calcification scores (Adragao, Kauppila), and ABPI were measured at baseline and after 1-year.
  • Patients were categorized into hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), and stage 4 chronic kidney disease (control) groups.

Main Results:

  • HD patients exhibited higher baseline carotid IMT and vascular calcification scores compared to CAPD patients.
  • These differences persisted after 1-year follow-up.
  • Pathological ABPI was more prevalent in the HD group. Dialysis type independently predicted increases in IMT and vascular calcification scores.

Conclusions:

  • Dialysis, especially hemodialysis, is an independent risk factor for increased cardiovascular calcification in ESRD patients.
  • Dialysis modality significantly influences vascular calcification progression.
Abstract

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