Risk factors for coronary artery calcification in patients on hemodialysis

Coronary artery calcification (CAC) is a predictor of poor survival and cardiovascular outcomes in patients with end-stage renal disease. This study assessed the risk factors for vascular calcification in patients on maintenance hemodialysis (HD).

In total, 71 patients who underwent HD in our hospital from January 2022 to September 2022 were enrolled. The general clinical data and laboratory results of the patients were collected and the CAC score was calculated.

CAC occurred in 41/71 patients (57.75%) in the study. Baseline characteristics including primary disease, height, weight, blood pressure, dialysis duration, smoking history, and comorbid hypertension rates did not significantly differ between patients with and without CAC. Compared with the findings in the calcification group, the non-calcification group had significantly higher fibrinogen (4.2 (3.7-5.3) vs 3.6 (3.1-4.5); p = 0.01) and ferritin levels (194.0 (85.2-288.0) vs 44.9 (18.0-170.5); p < 0.01) and lower calcium levels (2.2 (2.0-2.3) vs 2.3 (2.2-2.4); p < 0.01) and red blood cell counts (3.0 ± 0.8 vs 3.4 ± 0.7; p < 0.01). In logistic regression analysis, the risk of CAC was predicted by diabetes (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.37-28.11; p = 0.02) and the red blood cell count (OR = 2.99, 95% CI = 1.05-5.02; p = 0.04). Based on receiver operating characteristic curve analysis, the area under the curve of the red blood cell count for predicting the risk of CAC was 0.66 (p = 0.02), using a clinical diagnostic cutoff of 2.99 (sensitivity, 75.6%; specificity, 56.7%).

The incidence rate of CAC was high in patients on HD. Diabetes and elevated red blood cell count emerged as independent risk factors for predicting the risk of CAC in patients on HD.