Key result
The presence of aortic artery calcification was independently associated with an increased risk of all-cause mortality (HR 3.149) in maintenance hemodialysis patients.
Why the study?
Does the presence of aortic artery calcification or cardiac valve calcification predict mortality in maintenance hemodialysis patients?
Cohort (n=110)
No
Does the presence of aortic artery calcification or cardiac valve calcification predict mortality in maintenance hemodialysis patients?
Lateral lumbar X-ray and echocardiography are simple methods to detect aortic and cardiac valve calcification, which independently predict all-cause and cardiovascular mortality in maintenance hemodialysis patients.
Answers are grounded in this paper and cite their sources.
May flag higher-risk hemodialysis patients for monitoring; leaves open whether modifying calcification improves outcomes.
BACKGROUND: This study was to investigate the relationship among aortic artery calcification (AAC), cardiac valve calcification (CVC), and mortality in maintenance hemodialysis (MHD) patients. METHODS: All MHD patients in Shanghai Ruijin Hospital in July 2011 were included. To follow up for 42 months, clinical data, predialysis blood tests, echocardiography, and lateral lumbar X-ray plain radiography results were collected. Plasma FGF23 level was measured using a C-terminal assay. RESULTS: Totally, 110 MHD patients were involved in this study. Of which, 64 (58.2%) patients were male, the mean age was 55.2 ± 1.4 years old, and the median dialysis duration was 29.85 (3.0-225.5) months. About 25.5% of the 110 MHD patients had CVC from echocardiography while 61.8% of the patients had visible calcification of aorta from lateral lumbar X-ray plain radiography. After 42 months follow-up, 25 (22.7%) patients died. Kaplan-Meier analysis showed that patients with AAC or CVC had a significant greater number of all-cause and cardiovascular deaths than those without. In multivariate analyses, the presence of AAC was a significant factor associated with all-cause mortality (hazard ratio [HR]: 3.149, P = 0.025) in addition to lower albumin level and lower 25-hydroxy Vitamin D (25(OH)D) level. The presence of CVC was a significant factor associated with cardiovascular mortality (HR: 3.800, P = 0.029) in addition to lower albumin level and lower 25(OH)D level. CONCLUSION: Lateral lumbar X-ray plain radiography and echocardiography are simple methods to detect AAC and CVC in dialysis patients. The presence of AAC and CVC was independently associated with mortality in MHD patients. Regular follow-up by X-ray and echocardiography could be a useful method to stratify mortality risk in MHD patients.
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Chen et al. (2015) conducted a cohort in Maintenance hemodialysis (n=110). Aortic artery calcification (AAC) vs. Absence of AAC was evaluated on All-cause mortality (HR 3.149, 95% CI 0.889-11.159, p=0.025). The presence of aortic artery calcification was independently associated with an increased risk of all-cause mortality (HR 3.149) in maintenance hemodialysis patients.
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