The Progression Of Cardiovascular Calcification In Hemodialysis Patients:the Involving Factors And Its Effects On Outcomes

Objective To investigate the progression of cardiovascular calcification in hemodialysis patients and analyze the the involving factors and its effects on outcomesMethods Patients were voluntarily enrolled from Jinling Hospital whose vintage>6months.Besides routine laboratory examination,chest spiral CT、chest spiral CT and chest spiral CT were taken in the baseline and the 3rd year.We will calculate the Coronary artery calcification score(CACS)、abdominal aortic calcification score(AACS)and the cardiac valve calcification.We investigated the progression of cardiovascular calcification and its involving factors then analyze the effect of cardiovascular calcification on the prognosis of patients.Results:A total of 104 patients were enrolled in the study.One patient underwent kidney transplantation during the study period,one patient left our center,and 17 patients(16.34%)died;Among all the 17patients,6 died of cerebrovascular accidents,10 died of cardiovascular accidents,and 1 died of a car accident.A total of 85 patients completed the same examination of cardiovascular calcification in the third year.the baseline CAC was moderate-severe calcification in 25 patients(24.04%),79 patients(75.96%)have no CAC or be mild CAC at the baseline.The survival rate in the moderate-severe CAC group was lower than the other group(68%vs 88.6%in the 3rd years respectively,P=0.015).The second calcification examinations showed that 49 cases(57.6%)had CAC progression,29 cases(34.1%)showed abdominal aortic calcification progression,and 24 cases(28.2%)showed heart valve calcification progression,18 patients(21.2%)had no significantly calcification progress.The average of CACS,AACS,and cardiac valve calcification were all significantly worse than baseline(P<0.001).Logistic regression analysis showed that E/A value,Time-average phosphorus(TA-Pi),Time-average calcium*phosphorus(TA-Ca*Pi),baseline CACS,and calcium carbonate were all independent risk factors for CACS progression.Conclusion:The incidence of vascular calcification in hemodialysis patients was high,and it increases gradually with the prolongation of the vintage.The level of phosphorus、calcium phosphorus product index,baseline CACS all affected the long-term CAC progression.The control of serum phosphorus affects the patient’s long-term prognosis.