Fabbian Fabio, Catalano Carlo, Orlandi Valentina, Conte Maria Maddalena, Lupo Antonio, Catizone Luigi
Department of Nephrology, Arcispedale S. Anna, Ferrara, Italy.
J Nephrol. 2005 May-Jun;18(3):289-93.
In the general population, aortic arch calcification (AAC) is related to cardiovascular (CV) disease. Vascular calcifications are common findings in dialysis patients; therefore, we carried out a retrospective study evaluating which risk factors are associated to AAC in stable hemodialysis (HD) patients.
Standard posterior-anterior chest radiographs, performed the day after the midweek HD session in 132 patients (mean age 65 +/- 12 yrs) who had been on renal replacement therapy (RRT) for 33 months (range 1-471), were analyzed. Cardiothoracic ratio (CTR) was also calculated.
AAC was detected in 51% of patients. They were older (68 +/- 8 vs. 62 +/- 14 yrs; p = 0.003), were on RRT for longer (51 (range 2-471) vs. 22 (range 1-195) months; p = 0.0001), had greater CTR (54 (32-71) vs. 50% (40-65); p = 0.034) and higher prevalence of peripheral vascular disease (PVD) (40 vs. 17%; p = 0.049), whilst body weight was lower (62 +/- 14 vs. 68 +/- 14 kg; p = 0.04) than those without AAC. On the contrary, sex, diabetes frequency, smoking habit, history of hypertension and hyperphosphatemia, cerebrovascular and ischemic heart disease (IHD), blood pressure (BP) and antihypertensive therapy, lipids, albumin, degree of anemia, calcium, phosphate and their product were no different between the two groups. Logistic regression analysis showed that age (odds ratio (OR) 1.069 95% confidence interval (95% CI) 1.02-1.11; p = 0.003), length of time on RRT (OR 1.02 95% CI 1.01-1.03; p = 0.0002), calcium-phosphate product (OR 1.03 95% CI 1.007-1.07; p = 0.016), systolic BP (OR 1.03 95% CI 1.005-1.06; p = 0.02) and PVD (OR 3.08 95% CI 1.17-8.06; p = 0.02) were independently associated to AAC.
We conclude that AAC is related to atherosclerosis and to renal failure-related CV risk factors. A careful evaluation of a frequently performed investigation is useful in CV disease risk stratification in HD patients.
在普通人群中，主动脉弓钙化（AAC）与心血管（CV）疾病相关。血管钙化在透析患者中很常见；因此，我们进行了一项回顾性研究，以评估哪些危险因素与稳定血液透析（HD）患者的AAC相关。
对132例（平均年龄65±12岁）接受肾脏替代治疗（RRT）33个月（范围1 - 471个月）的患者在周中HD治疗次日进行的标准后前位胸部X线片进行分析。还计算了心胸比率（CTR）。
51%的患者检测到AAC。他们年龄更大（68±8岁对62±14岁；p = 0.003），接受RRT的时间更长（51（范围2 - 471）个月对22（范围1 - 195）个月；p = 0.0001），CTR更大（54%（32 - 71）对50%（40 - 65）；p = 0.034），外周血管疾病（PVD）患病率更高（40%对17%；p = 0.049），而体重低于无AAC的患者（62±14 kg对68±14 kg；p = 0.04）。相反，两组之间的性别、糖尿病发生率、吸烟习惯、高血压和高磷血症病史、脑血管和缺血性心脏病（IHD）、血压（BP）及抗高血压治疗、血脂、白蛋白、贫血程度、钙、磷及其乘积无差异。逻辑回归分析显示，年龄（比值比（OR）1.069，95%置信区间（95%CI）1.02 - 1.11；p = 0.003）、RRT时间长度（OR 1.02，95%CI 1.01 - 1.03；p = 0.0002）、钙磷乘积（OR 1.03，95%CI 1.007 - 1.07；p = 0.016）、收缩压（OR 1.
