Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey.
Department of Radiology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Turk J Med Sci. 2021 Oct;51(5):2607-2615. doi: 10.3906/sag-2104-221. Epub 2021 Oct 21.
Vascular calcifications (VCs), recognized risk factor for increased mortality, are highly prevalent in hemodialysis (HD) patients. We aimed to investigate the relation between VC and warfarin use with plain radiography.
VCs were assessed using Adragao (radial and digital) and Kauppila (aortic) scores in 76 HD patients from six centers. Out of a total 711 HD patients, there were 32 (4.5%) who had been treated with warfarin for at least 1 year, and we included 44 control patients.
Of the patients, 47% were females, the mean age was 66 ± 9 years, 23% were diabetics, the mean dialysis vintage was 68 ± 38 months. In warfarin group, median Kauppila score was higher than in control group [11 vs 6.5, (25%-75% percentile, 5 vs. 15), p = 0.032] and the percentage of the patients with a Kauppila score of >6 was higher, as well (76.6% vs. 50%; p = 0.029). Median Adragao score was not significantly different between the two groups [7 vs. 6, (%25,%75 percentile 6 vs. 8), p = 0.17]. Logistic regression analysis revealed that warfarin treatment was independently associated with Kauppila scores of >6 (OR 3.60, 95% CI 1.18-10.9, p = 0.024).
In this study, we found that warfarin is associated to vascular calcifications, especially in aorta of HD patients.
血管钙化（VCs）是死亡率增加的一个公认危险因素，在血液透析（HD）患者中非常普遍。我们旨在研究 VC 与华法林使用与普通 X 射线之间的关系。
在六个中心的 76 名 HD 患者中，使用 Adragao（桡动脉和数字）和 Kauppila（主动脉）评分评估 VC。在总共 711 名 HD 患者中，有 32 名（4.5%）至少接受了 1 年的华法林治疗，我们纳入了 44 名对照患者。
患者中，47%为女性，平均年龄为 66 ± 9 岁，23%为糖尿病患者，平均透析龄为 68 ± 38 个月。在华法林组中，Kauppila 评分中位数高于对照组[11 对 6.5，（25%-75%分位数，5 对 15），p = 0.032]，Kauppila 评分>6 的患者比例也更高，也是如此（76.6%对 50%；p = 0.029）。两组之间的 Adragao 评分中位数无显著差异[7 对 6，（25%，75%分位数 6 对 8），p = 0.17]。Logistic 回归分析表明，华法林治疗与 Kauppila 评分>6 独立相关（OR 3.60，95%CI 1.18-10.9，p = 0.024）。
在这项研究中，我们发现华法林与 HD 患者的血管钙化有关，尤其是主动脉。
