Abstract: SA-PO864

Do Hemodialysis and Peritoneal Dialysis Differ Regarding Their Effect on Coronary Calcification?

Session Information

  • Vascular Calcification
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

  • 1205 Vascular Calcification

Authors

  • Jansz, Thijs Thomas, University Medical Center Utrecht, Amsterdam, Netherlands
  • Van reekum, Franka E., University Medical Center Utrecht, Amsterdam, Netherlands
  • Ozyilmaz, Akin, University Medical Center Groningen, Groningen, Netherlands
  • Verhaar, Marianne C., University Medical Center Utrecht, Amsterdam, Netherlands
  • van Jaarsveld, Brigit C., VU medical center, Amsterdam, Netherlands

Group or Team Name

  • NOCTx investigators
Background

Identifying modifiable risk factors of vascular calcification in end-stage renal disease is crucial in light of the associated high cardiovascular morbidity and mortality. In this cross-sectional study, we compared coronary artery calcification and levels of biomarkers associated with vascular calcification in pts treated with hemodialysis (HD) and peritoneal dialysis (PD), respectively.

Methods

We assessed coronary artery calcification using multi-slice computed tomography in 121 pts treated with HD (≤ 16 hrs/wk) and 46 pts treated with PD, who were included in the NOCTx study (NCT00950573). Biomarker measurements were performed in a subset of 55 HD and 33 PD pts using enzyme-linking immuno-assays and multiplex assays. We adjusted for age, sex, dialysis vintage, diabetes mellitus, use of vitamin K antagonists, smoking and residual diuresis in multivariate analyses.

Results

Pts treated with HD were somewhat older (53.1 ± 12.2 versus 49.8 ± 15.1 years) and had been on dialysis longer (26, IQR 12 – 57 versus 14, IQR 7 – 33 months). In univariate and multivariate analyses, coronary artery calcification in HD pts (median score 208, IQR 1 – 809) was not significantly different from PD pts (median score 84, IQR 0 – 1066). In HD pts, phosphate levels tended to be higher compared with PD pts (1.68 ± 0.39 versus 1.59 ± 0.35 mmol/L). Osteoprotegerin was evidently lower in HD pts (2.95 ± 1.33 versus 3.43 ± 1.81 μg/L, p < 0.01), while inactive matrix Gla protein (dp-ucMGP) levels did not differ significantly between HD and PD pts. Only dp-ucMGP was independently associated with extent of coronary artery calcification. Inflammatory markers C-reactive protein, interleukin-1β and interleukin-6 did not differ significantly between HD and PD pts. Probably due to intermittent fluid overload in HD, NT-proBNP was significantly higher in HD pts (2217 ± 1817 versus 1045 ± 1372 pmol/l, p = 0.01).

Conclusion

Uremia per se is detrimental for the coronary vasculature, seemingly irrespective of treatment with HD or PD. Whether coronary artery calcification and its progression are affected by other renal replacement therapies needs further evaluation.

Funding

  • Commercial Support