Skip to main content

Advertisement

Log in

Assessment of abdominal aortic calcification at different stages of chronic kidney disease

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Vascular calcifications that may cause cardiovascular disease are highly prevalent in chronic kidney disease (CKD). In this study, we aimed to determine abdominal aorta calcifications (AAC) in predialysis and hemodialysis patients by lateral lumbar radiography and to investigate factors that were associated with the calcifications.

Methods

Two hundred and fifty-nine adult chronic hemodialysis patients, 300 predialysis CKD patients and 60 healthy subjects with normal kidney function as a control group were enrolled in the study. Lateral lumbar radiography was used to measure AAC. Calcified deposits of the abdominal aorta wall at the level of the first through fourth lumbar vertebrae were graded by a 24-point scoring system.

Results

AAC prevalence (AAC score ≥1) was significantly different in hemodialysis, predialysis and control groups (71.8, 45.7 and 33.3 %, respectively; p < 0.001). AAC prevalence in CKD stages 1, 2, 3, 4 and 5 predialysis patients was 26.6, 43.3, 40, 58.3 and 55 %, respectively. AAC scores of the hemodialysis group were higher than of the predialysis group (p < 0.001) and the control group (p < 0.001). AAC scores of the predialysis group were not higher than of the control group (p = 0.314). AAC scores of the hemodialysis group were significantly higher than of the control group (p < 0.001) and stage 1 (p < 0.001), stage 2 (p = 0.001) and stage 3 predialysis groups (p = 0.002). Age (p < 0.001), presence of diabetes mellitus (p < 0.001) and serum phosphorus levels (p = 0.011) were found to be independent predictors of calcification in the hemodialysis group. Age (p < 0.001), serum phosphorus levels (p = 0.007) and history of cardiovascular disease (p = 0.014) were found to be independent predictors of calcification in the predialysis group.

Conclusions

Abdominal aortic calcification is highly prevalent in the hemodialysis population. Strict phosphorus control should be implemented to the predialysis and hemodialysis patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Foley RN, Parfrey PS, Sarnak MJ (1998) Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 9(12 Suppl):S16–S23

    CAS  PubMed  Google Scholar 

  2. Keith DS, Nichols GA, Gullion CM et al (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164(6):659–663

    Article  PubMed  Google Scholar 

  3. Go AS, Chertow GM, Fan D et al (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351(13):1296–1305

    Article  CAS  PubMed  Google Scholar 

  4. Muntner P, He J, Hamm L, Loria C et al (2002) Renal insufficiency and subsequent death resulting from cardiovascular disease in the United States. J Am Soc Nephrol 13(3):745–753

    PubMed  Google Scholar 

  5. Goodman WG, London G, Amann K et al (2004) Vascular calcification in chronic kidney disease. Am J Kidney Dis 43(3):572–579

    Article  PubMed  Google Scholar 

  6. Dellegrottaglie S, Sanz J, Rajagopalan S (2006) Vascular calcification in patients with chronic kidney disease. Blood Purif 24(1):56–62

    Article  PubMed  Google Scholar 

  7. Bellasi A, Ferramosca E, Muntner P et al (2006) Correlation of simple imaging tests and coronary artery calcium measured by computed tomography in hemodialysis patients. Kidney Int 70(9):1623–1628

    Article  CAS  PubMed  Google Scholar 

  8. Okuno S, Ishimura E, Kitatani K et al (2007) Presence of abdominal aortic calcification is significantly associated with all-cause and cardiovascular mortality in maintenance hemodialysis patients. Am J Kidney Dis 49(3):417–425

    Article  PubMed  Google Scholar 

  9. Wilson PW, Kauppila LI, O’Donnell CJ et al (2001) Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality. Circulation 103(11):1529–1534

    Article  CAS  PubMed  Google Scholar 

  10. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention (2009) Treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl 113:S1–130

    Google Scholar 

  11. Levey AS, Bosch JP, Lewis JB et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470

    Article  CAS  PubMed  Google Scholar 

  12. K/DOQI clinical practice guidelines for chronic kidney disease (2002) evaluation, classification, and stratification. Am J Kidney Dis 39(2 Suppl 1):S1–266

    Google Scholar 

  13. Kauppila LI, Polak JF, Cupples LA et al (1997) New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study. Atherosclerosis 132(2):245–250

    Article  CAS  PubMed  Google Scholar 

  14. Braun J, Oldendorf M, Moshage W et al (1996) Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients. Am J Kidney Dis 27(3):394–401

    Article  CAS  PubMed  Google Scholar 

  15. Matsuoka M, Iseki K, Tamashiro M et al (2004) Impact of high coronary artery calcification score (CACS) on survival in patients on chronic hemodialysis. Clin Exp Nephrol 8(1):54–58

    Article  PubMed  Google Scholar 

  16. Qunibi WY, Abouzahr F, Mizani MR et al (2005) Cardiovascular calcification in Hispanic Americans (HA) with chronic kidney disease (CKD) due to type 2 diabetes. Kidney Int 68(1):271–277

    Article  PubMed  Google Scholar 

  17. Fox CS, Larson MG, Keyes MJ et al (2004) Kidney function is inversely associated with coronary artery calcification in men and women free of cardiovascular disease: the Framingham Heart Study. Kidney Int 66(5):2017–2021

    Article  PubMed  Google Scholar 

  18. Hanada S, Ando R, Naito S et al (2010) Assessment and significance of abdominal aortic calcification in chronic kidney disease. Nephrol Dial Transplant 25(6):1888–1895

    Article  PubMed  Google Scholar 

  19. Garcia-Canton C, Bosch E et al (2011) Vascular calcification and 25-hydroxyvitamin D levels in non-dialysis patients with chronic kidney disease stages 4 and 5. Nephrol Dial Transplant 26(7):2250–2256

    Article  CAS  PubMed  Google Scholar 

  20. Honkanen E, Kauppila L, Wikstrom B et al (2008) Abdominal aortic calcification in dialysis patients: results of the CORD study. Nephrol Dial Transplant 23(12):4009–4015

    Article  PubMed  PubMed Central  Google Scholar 

  21. Toussaint ND, Pedagogos E, Lau KK et al (2011) Lateral lumbar X-ray assessment of abdominal aortic calcification in Australian haemodialysis patients. Nephrology (Carlton) 16(4):389–395

    Article  Google Scholar 

  22. Temmar M, Liabeuf S, Renard C et al (2010) Pulse wave velocity and vascular calcification at different stages of chronic kidney disease. J Hypertens 28(1):163–169

    Article  CAS  PubMed  Google Scholar 

  23. Moe SM, O’Neill KD, Fineberg N et al (2003) Assessment of vascular calcification in ESRD patients using spiral CT. Nephrol Dial Transplant 18(6):1152–1158

    Article  CAS  PubMed  Google Scholar 

  24. London GM, Guerin AP, Marchais SJ et al (2003) Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 18(9):1731–1740

    Article  PubMed  Google Scholar 

  25. Mehrotra R, Budoff M, Christenson P et al (2004) Determinants of coronary artery calcification in diabetics with and without nephropathy. Kidney Int 66(5):2022–2031

    Article  PubMed  Google Scholar 

  26. Yamada K, Fujimoto S, Nishiura R et al (2007) Risk factors of the progression of abdominal aortic calcification in patients on chronic haemodialysis. Nephrol Dial Transplant 22(7):2032–2037

    Article  PubMed  Google Scholar 

  27. Tentori F, Blayney MJ, Albert JM et al (2008) Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 52(3):519–530

    Article  CAS  PubMed  Google Scholar 

  28. Goodman WG, Goldin J, Kuizon BD et al (2000) Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342(20):1478–1483

    Article  CAS  PubMed  Google Scholar 

  29. Raggi P, Boulay A, Chasan-Taber S et al (2002) Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol 39(4):695–701

    Article  PubMed  Google Scholar 

  30. Shigematsu T, Kono T, Satoh K et al (2003) Phosphate overload accelerates vascular calcium deposition in end-stage renal disease patients. Nephrol Dial Transplant 18(Suppl 3):86–89

    Google Scholar 

  31. Goldsmith DJ, Covic A, Sambrook PA, Ackrill P (1997) Vascular calcification in long-term haemodialysis patients in a single unit: a retrospective analysis. Nephron 77(1):37–43

    Article  CAS  PubMed  Google Scholar 

  32. Toussaint ND, Lau KK, Strauss BJ et al (2009) Relationship between vascular calcification, arterial stiffness and bone mineral density in a cross-sectional study of prevalent Australian haemodialysis patients. Nephrology (Carlton) 14(1):105–112

    Article  Google Scholar 

  33. Toussaint ND, Lau KK, Strauss BJ et al (2008) Associations between vascular calcification, arterial stiffness and bone mineral density in chronic kidney disease. Nephrol Dial Transplant 23(2):586–593

    Article  PubMed  Google Scholar 

  34. Kestenbaum B, Sampson JN, Rudser KD et al (2005) Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol 16(2):520–528

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zeynep Biyik.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Biyik, Z., Selcuk, N.Y., Tonbul, H.Z. et al. Assessment of abdominal aortic calcification at different stages of chronic kidney disease. Int Urol Nephrol 48, 2061–2068 (2016). https://doi.org/10.1007/s11255-016-1413-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-016-1413-x

Keywords

Navigation