Kidney Week

Abstract: SA-PO0478

Reduced Cardiovascular Functional Capacity (Peak VO2) Is Associated with Higher Coronary Artery Calcium Burden in Patients on Hemodialysis

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Campos, Monique Opuszcka, Indiana University School of Medicine, Indianapolis, Indiana, United States

Monique Opuszcka Campos, PhD

• Stafford, Lauren H., Indiana University School of Medicine, Indianapolis, Indiana, United States

Lauren H. Stafford, MS

• Dillman, Drake, Indiana University School of Medicine, Indianapolis, Indiana, United States

Drake Dillman, MS

• Narayanan, Gayatri, Indiana University School of Medicine, Indianapolis, Indiana, United States

Gayatri Narayanan, MS

• Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States

Kenneth Lim, MD, PhD, FASN

Background

Coronary artery calcification (CAC) is highly prevalent in hemodialysis (HD) patients and is highly predictive of cardiac events and mortality. Peak oxygen uptake (VO₂Peak) is the gold-standard of CV functional capacity and is markedly impaired in this population. However, the association between CAC burden and directly measured CV functional capacity is largely unknown in patients with HD. Herein, we investigate the link between CAC score and VO₂Peak in patients receiving HD.

Methods

This is a cross-sectional analysis of baseline data from 54 patients on thrice-weekly hemodialysis from the ongoing Redefining Cardiovascular Risk Assessment in Dialysis Patients (ROCK-D) study. Cardiopulmonary exercise testing, magnetic resonance imaging (left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI)), and cardiac computed tomography (for CAC score) were performed the day following routine dialysis. The cohort was stratified dichotomously by VO₂Peak (≤11.5 vs >11.5 mL/kg/min).

Results

Groups were well-matched by gender and BMI (all P's>0.05). Patients with lower VO₂Peak (<11.5 mL/kg/min) were slightly older than those with higher VO₂Peak (>11.5 mL/kg/min) (54.0 [ 49.0, 63.0] vs 49.0 [40.0, 57.0] years; P=0.038). Medication use and comorbidities were similar (all P>0.05), and dialysis vintage trended longer (41.0 vs. 29.0 months) in the lower VO₂Peak group but was not significantly different (P=0.21). The lower VO₂Peak group had greater impairment in other CPET indices, including blunted chronotropic response (96.8 ± 12.7 vs 119.0 ± 17.6 bpm), workload (45.7 ± 16.3 vs 80.9 ± 25.6 watts) and endurance time (6.7 [5.3, 8.8] vs 8.0 [7.2, 10.0] min) (all P's <0.05). LVEF and LVMI were similar between groups (P>0.05). Significantly, higher CAC scores were observed in the lower VO₂Peak group (409.0 [50.3, 1,117] vs. 0.6 [0.0, 279.9]; P=0.007). VO₂Peak was inversely correlated with CAC score (r=−0.30, P=0.04), and remained independently associated after adjustment for age, sex, dialysis vintage and LVEF (β =−0.001, P=0.042).

Conclusion

Reduced CV functional capacity as assessed by VO₂Peak may be a predictor of underlying coronary disease, independent of cardiac remodeling in dialysis patients.

Funding

• Other NIH Support