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Abstract: TH-PO0472

Predictive Value of the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index on Predicting Vascular Calcification and Bone Mineral Density in Patients on Dialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Youn, Sojung, The Catholic University of Korea Bucheon St Mary's Hospital, Bucheon-si, Gyeonggi-do, Korea (the Republic of)
  • Kang, Donghyuk, The Catholic University of Korea Bucheon St Mary's Hospital, Bucheon-si, Gyeonggi-do, Korea (the Republic of)
  • Kim, Sungmi, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
  • Ban, Tae Hyun, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
  • Choi, Bumsoon, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
  • Yoon, Sunae, The Catholic University of Korea Uijeongbu St Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Korea (the Republic of)
  • Kim, Ji Eun, Korea University Guro Hospital, Guro-gu, Seoul, Korea (the Republic of)
  • Ahn, Shin-Young, Korea University Guro Hospital, Guro-gu, Seoul, Korea (the Republic of)
  • Ko, Gang Jee, Korea University Guro Hospital, Guro-gu, Seoul, Korea (the Republic of)
  • Kwon, Young-Joo, Korea University Guro Hospital, Guro-gu, Seoul, Korea (the Republic of)
  • Hong, Yu Ah, The Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)

Group or Team Name

  • On behalf of the ORCHESTRA Study Investigators.
Background

CALLY index is a composite biomarker that reflects nutritional, immunological, and inflammatory status. This study aimed to evaluate the clinical significance of the CALLY index in predicting vascular calcification and bone mineral density in patients undergoing dialysis.

Methods

This cross-sectional study analyzed baseline data from 17 multicenter prospective cohorts of dialysis patients in Korea. A total of 683 patients were stratified into tertiles using CALLY index, calculated as (albumin×lymphocyte count)/C-reactive protein. Abdominal aortic calcification score (AACS) was assessed via spine radiographs, with significant vascular calcification defined as AACS ≥4. Logistic regression analyses were performed to examine associations between CALLY index and both vascular calcification and osteoporosis.

Results

The mean age of patients was 59.3 ± 11.8 years, and the mean CALLY index was 5.9 ± 12.8. The highest CALLY index tertile had a lower proportion of males and a lower prevalence of diabetes. Compared to the lowest tertile, patients in the highest were younger and had lower Charlson comorbidity index, fasting glucose, intact parathyroid hormone levels, but higher magnesium levels. AACS was significantly lower in the highest tertile (p=0.005), while T-scores at L1-L4, femur neck, and total hip showed no significant differences across the groups.

In univariable analysis, the highest CALLY index tertile was independently associated with a lower risk of significant vascular calcification (odds ratio [OR] 0.492, 95% confidence interval [CI] 0.339–0.715, p<0.001). This association remained significant after full adjustment for confounding factors in the multivariable model (OR 0.580, 95% CI 0.342–0.984, p=0.043). Furthermore, area under the curve (AUC) of significant vascular calcification was 0.578 (95% CI 0.535–0.621) in the univariable model, and increased to 0.777 (95% CI 0.738–0.816) after full adjustment. Whereas, the CALLY index was not associated with osteoporosis in either univariable or multivariable model.

Conclusion

A higher CALLY index is independently associated with a lower risk of significant vascular calcification in dialysis patients, suggesting its potential role as a biomarker in risk stratification.

Funding

  • Commercial Support – Kyowa Kirin Korea Co., Ltd.

Digital Object Identifier (DOI)