Aortic Artery and Cardiac Valve Calcification are Associated with Mortality in Chinese Hemodialysis Patients: A 3.5 Years Follow-up
- Author:
- No author available
- Journal Title:
- Chinese Medical Journal
- Issue:
- 20
- DOI:
- 10.4103/0366-6999.167315
- Key Word:
- FGF23;Hemodialysis;Mortality;Vascular Calcification
Abstract： Background:This study was to investigate the relationship among aortic artery calcification (AAC),cardiac valve calcification (CVC),and mortality in maintenance hemodialysis (MHD) patients.Methods:All MHD patients in Shanghai Ruijin Hospital in July 2011 were included.To follow up for42 months,clinical data,predialysis blood tests,echocardiography,and lateral lumbar X-ray plain radiography results were collected.Plasma FGF23 level was measured using a C-terminal assay.Results:Totally,110 MHD patients were involved in this study.Of which,64 (58.2％) patients were male,the mean age was 55.2 ± 1.4 years old,and the median dialysis duration was 29.85 (3.0-225.5) months.About 25.5％ of the 110 MHD patients had CVC from echocardiography while 61.8％ of the patients had visible calcification of aorta from lateral lumbar X-ray plain radiography.After 42 months follow-up,25 (22.7％) patients died.Kaplan-Meier analysis showed that patients with AAC or CVC had a significant greater number of all-cause and cardiovascular deaths than those without.In multivariate analyses,the presence of AAC was a significant factor associated with all-cause mortality (hazard ratio [HR]:3.149,P =0.025) in addition to lower albumin level and lower 25-hydroxy Vitamin D (25(OH)D)level.The presence of CVC was a significant factor associated with cardiovascular mortality (HR:3.800,P =0.029) in addition to lower albumin level and lower 25(OH)D level.Conclusion:Lateral lumbar X-ray plain radiography and echocardiography are simple methods to detect AAC and CVC in dialysis patients.The presence of AAC and CVC was independently associated with mortality in MHD patients.Regular follow-up by X-ray and echocardiography could be a useful method to stratify mortality risk in MHD patients.
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