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Abstract: FR-PO350

No Association Was Observed Between Aortic Arch Calcification and Mortality in Hemodialysis Patients

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Author

  • Hamada, Toma, Kanto rosai hospital, Kanagawa prefecture Nakahara ward kizuki sumiyoshicho 1-1, Japan

Group or Team Name

  • Team Yokochi
Background

Vascular Calcification (VC) is common in end-stage renal disease. Previous reports have shown that Aortic Arch Calcification (AoAC) score is associated with poor outcomes in general population. We assessed the utility of AoAC score at initiation of hemodialysis.

Methods

In this study, 115 patients who initiated Hemodialysis in our facility from January 2010 to December 2013 were retrospectively analyzed. The follow-up period was 3 years, and we excluded patients who underwent renal transplantation, transfered to other hospital, and lost to follow up.Two nephrologists retrospectively reviewed chest X-rays to count AoAC score. Using specific scale, we counted the calcification parts from 0 to 16. Patients were classified into 2 groups based on AoAC score : High AoAC score (HC) group (AoAC score ≧ 7) and Low AoAc score (LC) group (AoAC score < 7), and we compared clinical characteristics and outcomes among both groups. Analyses were performed using JMP.

Results

Overall 155 patients were included in the study, 66 % of them were male, mean age was 70.0 ± 10.6 years, mean AoAC score was 6.5 ± 3.6. There was highly significant correlationship between the two nephrologist’s AoAC score (r = 0.95, p < 0.05 ). AoAC score was correlated with age (r = 0.42, p < 0.05) and alkaline phosphatase (ALP) ( r = 0.21, p < 0.05), was not correlated with serum phosphate (p = 0.75) and calcium (p =0.50). Kaplan-Meier analysis showed that all-cause mortality rates were significantly higher in HC group compared with LC group (p < 0.05). Logistic regression analysis revealed that HC group patients were significantly high to die within 3 years after initiation of hemodialysis (unadjusted odds ratio 2.90; 95 % CI 1.16 – 7.78; p < 0.05). But, after adjustment for age, sex, presence of diabetes, serum phosphate, calcium, ALP, HC group did not have higher mortality compared with LC group (adjusted odds ratio 1.71; 95 % CI 0.61 – 4.99; p = 0.30).

Conclusion

These results suggested that the severity of Aortic Arch Calcification at initiation of hemodialysis was not an independent risk factor for mortality. But it is well-known, the progression of calcification is associated with poor outcomes, further studies are needed to solve the mechanism of this mysterious discrepancy.