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Intra-Cranial Arterial Calcifications in Hemodialysis Patients

Feda Fanadka1, Ilan Rozenberg2,3, Naomi Nacasch2,3

  • 1Department of Radiology, Meir Medical Center, Kfar Saba 4428164, Israel.

Medicina (Kaunas, Lithuania)
|October 28, 2023
PubMed

Insights

Intracranial arterial calcifications (ICAC) are highly prevalent in maintenance hemodialysis (MHD) patients. Increased ICAC scores independently predict mortality, suggesting their utility in risk stratification for this population.

Area of Science:

  • Nephrology
  • Cardiology
  • Neurology

Background:

  • Vascular calcification is a key feature of atherosclerosis and a risk factor for cardiovascular disease.
  • Intracranial arterial calcifications (ICAC) are common in patients undergoing maintenance hemodialysis (MHD).

Purpose of the Study:

  • To evaluate predictors and outcomes of ICAC in MHD patients.
  • To compare ICAC prevalence and severity between MHD patients and a control group with normal kidney function.

Main Methods:

  • Retrospective study design.
  • Neuroradiologist blinded assessment of ICAC using computerized tomography scans.
  • Comparison of 140 MHD patients with 140 age- and sex-matched controls.

Main Results:

  • MHD patients exhibited significantly higher mean ICAC scores (2.3 ± 0.2) compared to controls (1.4 ± 0.2).
  • Over 90% of MHD patients showed some degree of ICAC.
  • Lower albumin, higher phosphorus, and higher CRP levels correlated with increased ICAC.
  • Higher ICAC scores were associated with increased 1-year mortality risk.

Conclusions:

  • ICAC in MHD patients involves complex inflammatory and vascular processes, not just passive calcification.
  • ICAC is an independent predictor of all-cause mortality in MHD patients.
  • ICAC can aid in risk stratification for MHD patients.

Keywords:
arterial calcificationatherosclerosisend stage kidney diseasehemodialysis

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