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Abstract: PO0595

Bone-Vessel Relationships, the Association Between Calcifications of the Iliac Arteries with Vertebral Fractures in Hemodialysis Patients: Results from the VIKI Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Fusaro, Maria, National Research Council (CNR), Institute of Clinical Physiology (IFC), Reggio Calabria, Italy
  • Politi, Cristina, CNR-IFC, Reggio Calabria, Italy
  • Aghi, Andrea, Department of Medicine, Clinica Medica 1, University of Padua, Padova, Italy
  • Taddei, Fulvia, Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy, Bologna, Italy
  • Schileo, Enrico, Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy, Bologna, Italy
  • Nickolas, Thomas, Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, NewYork, New York, United States
  • Khairallah, Pascale, Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, NewYork, New York, United States
  • Gallieni, Maurizio, Nephrology and Dialysis Unit, Azienda Socio-Sanitaria Territoriale (ASST) Fatebenefratelli Sacco, Department of Clinical and Biomedical Sciences 'Luigi Sacco', Università di Milano, Milano, Italy
  • Mereu, Maria cristina Mc, Independent Researcher, Cagliari, Italy
  • Tripepi, Giovanni, CNR-IFC, Reggio Calabria, Italy
Background

Vascular calcification and fragility fractures are common age-related disorders and associated with high morbidity and mortality especially in end-stage renal disease. Skeletal disorders occur in dialysis patients. Few studies have provided data on the prevalence of vertebral fractures (VFs) and their association with large artery calcifications. We evaluated the relationship of iliac arteries calcifications (IACs) and abdominal aorta calcifications (AACs) with the risk for VFs in hemodialysis (HD) patients

Methods

The VIKI Study is a cross-sectional study involving 387 HD patients from 18 Italian dialysis centers. Biochemical data included bone health markers such as vitamin K levels, vitamin 25(OH)D, alkaline phosphatase, parathormone, calcium, phosphate, osteocalcin and Matrix Gla Protein. The presence of VF, IACs and AACs were determined through standardized spine lateral radiographs. A >20% reduction of vertebral body height was considered a VF. We quantified vascular calcifications by measuring the length of calcium deposits along the arteries classifying the degree of severity for the IACs and AACs with a specific score (mild: 0.1–3 cm; moderate: 3.1–5 cm; and severe >5 cm) previously validated for AACs.

Results

The prevalence of IACs was 56.1%, and of AACs 80.6%. After adjusting for confounding variables, the presence of IACs was associated with 73% higher odds of VF (p=0.028), whereas we found no association (p=0.294) for AACs. The presence of IACs associated with VF irrespective of calcification severity. Patients with IACs had lower levels of the vitamin K2, menaquinone 7 (MK7) (0.99 vs 1.15 ng/ml; p=0.003), and deficiency of this marker became greater when adjusting for triglyceride levels (0.57 vs 0.87 ng/ml; p<0.001).

Conclusion

The presence of IACs, regardless of their extent, appears to be a clinically relevant risk factor for VFs. The association is further enhanced by including vitamin K, a main player in bone and vascular health, in the model. Prospective studies are needed to confirm these findings both in chronic kidney disease patients and in the general population.

Funding

  • Private Foundation Support