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Arteriosclerosis in dialysis patients

J Bommer¹, E Strohbeck, J Goerich

¹Medizinische Universitätsklinik, Heidelberg, Germany.

The International Journal of Artificial Organs

|November 1, 1996

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Chronic hemodialysis accelerates arteriosclerosis, particularly in the abdominal aorta. This condition is linked to factors like age, smoking, and metabolic disturbances common in dialysis patients.

Area of Science:

Nephrology
Cardiovascular Medicine
Radiology

Background:

Arteriosclerosis is a significant complication for patients undergoing long-term hemodialysis.
Computer tomography (CT) provides a reliable method for assessing aortosclerosis.

Purpose of the Study:

To evaluate the prevalence and progression of aortosclerosis in chronic hemodialysis patients.
To identify risk factors associated with accelerated and progressive aortosclerosis in this population.

Main Methods:

Cross-sectional study comparing aortosclerosis in hemodialysis patients versus controls using CT.
Longitudinal study tracking aortosclerosis progression over time in hemodialysis patients using serial CT scans.

Main Results:

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Hemodialysis patients exhibited significantly accelerated aortosclerosis compared to age-matched controls.
Risk factors included age, smoking, dialysis duration, dyslipidemia (elevated VLDL, reduced HDL), hypertriglyceridemia, elevated uric acid, and calcium-phosphate product.
Parathyroidectomy was associated with reduced aortosclerosis progression.

Conclusions:

Patients on maintenance hemodialysis experience premature and accelerated arteriosclerosis.
Disturbances in calcium-phosphate and parathyroid hormone metabolism are key contributors to aortosclerosis in dialysis patients, beyond common risk factors.