Analysis of some risk factors of coronary and valvular calcification in peritoneal dialysis

Abstract

OBJECTIVE: Our study was performed to analyze risk factors for coronary artery calcification (CAC) and valvular calcification (VC) in peritoneally dialyzed patients, as well as the frequency of fatal cardiovascular complications. METHODS: The study was performed on 102 peritoneal dialyzed patients (mean time of dialysis: 37.3 ± 23 months). Patients were divided depending on the severity of calcification into three groups: A, lack of calcification; B, CAC up to 400 mm3; and C, CAC >400 mm 3. CAC and VC were measured by means of computed tomography. The following risk factors for CAC and VC were analyzed: age, gender, time of peritoneal dialysis, and levels of calcium, phosphates, calcium x phosphorus product (Ca x P), C-reactive protein (CRP), fibrinogen, fetuin-A, and parathormone (PTH). RESULTS: Positive correlation was found between CAC and VC expressed by Agatston and volumetric score, and serum levels of CRP and fibrinogen and patient age. In patients with CAC and VC, serum levels of phosphorus and Ca x P were significantly higher; however, such significance was not observed in patients with CAC only. Serum fetuin-A was decreased in all study groups, and was significantly lower in patients with CAC and VC than in patients with CAC only. Cardiovascular complications were significantly more frequent and mortality was higher in group C than in groups A and B. CONCLUSIONS: In peritoneally dialyzed patients, CAC accompanied by VC is a high risk factor for mortality resulting from cardiovascular complications.