Vascular calcifications in subjects with and without chronic renal failure: types, sites and risk factors

Abstract

Vascular calcifications worse outcomes in the general population and in patients on dialysis

We investigated 146 patients on chronic hemodialysis and 63 healthy controls with normal renal function under 65 years of age. All subjects underwent B-mode ultrasonography of common and internal carotid artery, abdominal aorta, common and superficial femoral artery and posterior tibial artery to assess the presence of intimal and medial calcifications.

Intimal and media calcifications were present at the level of the carotid vessel, the abdominal aorta, the common femoral artery, the superficial femoral artery and the posterior tibial artery, respectively in 45%, 50%, 45%, 50%, 42% of patients on dialysis and in 5%, 15%, 24%, 5%, 2% of controls (p <0,01).

On multivariate logistic analysis of regression, after adjustment for potential confounders,    carotid intimal calcification, abdominal aortic calcification, medial calcification of the superficial femoral artery and posterior tibial artery calcification were associated with dialysis and with cardiovascular disease. Only intimal arterial calcification were associated with older age and smoking.

Vascular calcifications are extremely common in middle-aged patients on chronic hemodialysis. Ultrasonography currently available in Nephrology, is a sensitive, reproducible, inexpensive imaging technique to identify arterial intimal and medial calcification in high-risk cardiovascular subjects.

Key words: arterial calcifications, arterial intimal calcifications, arterial media calcification, chronic renal failure, hemodialysis, vascular calcifications

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Introduzione

La presenza di calcificazioni vascolari aumenta il rischio di mortalità cardiovascolare nei soggetti sani (1,2), nei cardiopatici (3), nei diabetici (4) e nei nefropatici (5). Considerando i differenti distretti arteriosi, questa associazione tra calcificazione vascolare e mortalità è stata dimostrata per il distretto arterioso carotideo (6), aortico addominale (7), femorale comune (8), femorale superficiale (9) e tibiale (10).
 

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