International Urology and Nephrology

, Volume 50, Issue 5, pp 939–946 | Cite as

Prognostic value of cardiovascular calcifications in hemodialysis patients: a longitudinal study

  • Nada DimkovicEmail author
  • Georg Schlieper
  • Aleksandar Jankovic
  • Zivka Djuric
  • Marcus Ketteler
  • Tatjana Damjanovic
  • Petar Djuric
  • Jelena Marinkovic
  • Zoran Radojcic
  • Natasa Markovic
  • Jürgen Floege
Nephrology - Original Paper



Cardiovascular calcifications (CVC) are present in up to 70% of non-diabetic dialysis patients. Sparse data are available on predictors of very long-term outcomes of such patients. The Belgrade Aachen Study on Calcification in Hemodialysis patients (BASCH study) aimed to study this using a comprehensive CVC assessment.


We prospectively analyzed 220 hemodialysis patients followed for a mean of 76 months (median 73 months, range 6–160 months). We compared patients deceased from cardiovascular diseases (CVD) and survivors. Analyses included composite calcification scores (determined by combining ultrasound and X-ray analyses), demographic, clinical and laboratory data and pulse wave velocity (PWV). For survival analysis, patients were divided into group according to quartiles (Q).


Compared to survivors, deceased patients from CVD were significantly older, more frequently hypertensive, had shorter dialysis times per week and lower Kt/V values, and they exhibited lower serum fetuin A, osteoprotegerin and hemoglobin as well as higher CRP levels. Composite calcification and Adragao scores were significantly higher in deceased patients from CVD as was PWV. Mean survival was 101 ± 47 months (Q1), 87 ± 51 month (Q2), 66 ± 48 (Q3) and 54 ± 45 months (Q4), p = 0.000. Cox multivariate regression analysis showed that independent predictors for cardiovascular mortality were composite calcification score in the range of third and fourth quartiles.


Composite calcification score emerged as significant predictors of long-term survival in our group of largely non-diabetic dialysis patient population, finding that should be confirmed by intervention studies.


Cardiovascular calcifications Hemodialysis Calcification inhibitors Calcification promoters Long-term survival 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Nada Dimkovic
    • 1
    • 2
    Email author
  • Georg Schlieper
    • 3
  • Aleksandar Jankovic
    • 2
  • Zivka Djuric
    • 2
  • Marcus Ketteler
    • 4
  • Tatjana Damjanovic
    • 2
  • Petar Djuric
    • 2
  • Jelena Marinkovic
    • 5
  • Zoran Radojcic
    • 6
  • Natasa Markovic
    • 2
  • Jürgen Floege
    • 3
  1. 1.School of MedicineUniversity of BelgradeBelgradeSerbia
  2. 2.Clinical Department for Renal DiseasesZvezdara University Medical CenterBelgradeSerbia
  3. 3.Department of Nephrology and Clinical ImmunologyRWTH Aachen UniversityAachenGermany
  4. 4.Klinikum Coburg GmbHCoburgGermany
  5. 5.School of Medicine, Institute of Medical Statistics and InformaticsUniversity of BelgradeBelgradeSerbia
  6. 6.Laboratory for Statistics, Faculty of Organizational SciencesUniversity of BelgradeBelgradeSerbia

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