期刊
NEPHROLOGY DIALYSIS TRANSPLANTATION
卷 19, 期 4, 页码 885-891出版社
OXFORD UNIV PRESS
DOI: 10.1093/ndt/gfh001
关键词
atherosclerosis; B-mode Doppler ultrasonography; electron beam computed tomography; haemodialysis; vascular calcification
Background. Coronary artery calcification scores (CACS) calculated by electron beam computed tomography (EBCT) have been correlated with atherosclerotic burden in the non-uraemic population. However, the validity of this test in. chronic haemodialysis patients (HD) is currently uncertain. In the present cross-sectional study, associations between carotid atherosclerosis and coronary calcification in HD patients are investigated. Methods. We studied 79 chronic HD patients (39 male, 40 female; mean age, 45 +/- 12 years). The mean time on HD was 68 +/- 54 months (range, 6-187 months). In these patients, we measured serum calcium, phosphorus, total cholesterol, cholesterol subgroups and iPTH levels. EBCT, echocardiography, and high-resolution B-mode carotid Doppler ultrasonography were also performed. Results. Plaque-positive HD patients had significantly higher CACS than plaque-negative patients (851 +/- 199 vs 428 +/- 185, mean +/- SE, P = 0.006). Coronary calcification scores were correlated with serum phosphorus (r = 0.37; P = 0.001). Only 8 of the 24 HD patients without coronary calcification had carotid plaques (33%), whereas 34 of the 53 patients with coronary calcification had carotid plaques (64%) (P = 0.015). Carotid plaque scores were correlated with CACS (r = 0.40; P = 0.001). A stepwise linear regression (model r = 0.72; P < 0.001) revealed that CACS (log-transformed data of CACS) was associated with age (P < 0.001), time on dialysis (P = 0.004), serum phosphorus level (P = 0.016) and carotid plaque scores (P = 0.037). Conclusions. Atherosclerosis is independently associated with coronary artery calcification and with hyperphosphataemia in chronic HD patients. CACS appeared to be predictive of both coronary atherosclerosis and carotid atherosclerosis.
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