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Risk factors for coronary artery calcification in Chinese patients undergoing maintenance hemodialysis: a

Mengjiao Li1, Yuxia Li2, Shuting Liu1

  • 1Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Pudong New Area, Shanghai, 201203, China.

International Urology and Nephrology
|May 2, 2025
PubMed

Insights

Diabetes and high parathyroid hormone levels are key risk factors for coronary artery calcification in Chinese maintenance hemodialysis patients. Monitoring these and other factors can help prevent cardiovascular disease progression.

Area of Science:

  • Nephrology
  • Cardiology
  • Public Health

Background:

  • Chronic kidney disease (CKD) progression to end-stage renal disease (ESRD) significantly elevates cardiovascular disease (CVD) risk.
  • Coronary artery calcification (CAC) affects a majority of Chinese maintenance hemodialysis (MHD) patients, exacerbated by prolonged dialysis and mineral imbalances.
  • Existing research on CAC risk factors in MHD patients lacks consensus due to methodological variations.

Purpose of the Study:

  • To systematically analyze the risk factors associated with coronary artery calcification (CAC) in Chinese patients undergoing maintenance hemodialysis (MHD).

Main Methods:

  • A comprehensive meta-analysis of 24 observational studies (cohort, case-control, cross-sectional) involving 2,875 Chinese MHD patients was conducted.
  • Studies were identified through a systematic search of ten databases up to October 21, 2024, adhering to PRISMA guidelines.
  • Risk factors were assessed using Odds Ratios (ORs) and 95% Confidence Intervals (CIs), with study quality evaluated by the Newcastle-Ottawa Scale.

Main Results:

  • Diabetes mellitus (OR=2.32) and elevated intact parathyroid hormone (iPTH) (OR=1.59) emerged as the strongest predictors of CAC in Chinese MHD patients.
  • Other significant predictors included elevated high-sensitivity C-reactive protein (hs-CRP), serum calcium, advanced age, longer dialysis duration, serum phosphorus, and sclerostin (SOST).
  • No significant correlation was found between CAC and hypertension, serum magnesium, FGF-23, or ALP, potentially due to study heterogeneity.

Conclusions:

  • Diabetes mellitus and elevated iPTH are critical clinical risk factors for CAC in Chinese MHD patients, necessitating focused clinical attention.
  • Monitoring calcium-phosphorus metabolism and inflammatory markers (hs-CRP, SOST) is crucial for mitigating CVD risk.
  • Implementing early health education and tailored treatment strategies for high-risk MHD patients can prevent and delay CAC development and progression.
Abstract

Keywords:
Coronary artery calcificationMaintenance hemodialysisMeta-analysisRisk factors

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