SP572THE PREVALENCE AND SEVERITY OF VASCULAR CALCIFICATION IN DIALYSIS DEPENDENT END STAGE RENAL DISEASE PATIENTS OF NORTHERN INDIA AND ITS RELATIONSHIP WITH PARATHYROID HORMONE LEVELS

Abstract

INTRODUCTION AND AIMS: Introduction: Coronary artery calcification (CAC) is an accepted tool for cardiovascular (CV) risk assessment in high risk CKD population. These high risk patients may benefit from (i) a lower threshold for performing preventive cardiovascular screening procedures, (ii) more intense monitoring during CV stress, (iii) less calcifying mineral metabolism treatment regimens Secondary hyperparathyroidism has been linked to vascular calcification (VC) and associated cardiovascular mortality in this population. The data regarding CAC score in Indian patients is scarce and studies relating its relationship with parathyroid hormone (PTH) levels have given conflicting results.Aims: To study the prevalence and severity of vascular calcification in dialysis dependent end stage renal disease patients of northern India and its relationship with parathyroid hormone levels METHODS: Inclusion criteria-all end stage renal disease (ESRD) patients receiving hemodialysis (twice weekly dialysis for a 4 hour period) or peritoneal dialysis aged between 18-60 years willing to participate in the study All subjects with known cardiovascular disease were excluded. Agaston scoring was used for evaluation of CAC Score and Thoracic Aortic Calcificaion Score (TACS). Demographic and biochemical details were recorded. RESULTS: In this cross sectional study of 65 patients from Northern India, mean age was 39.94611.24 years. Vascular calcification was noted in 43.08% of patients. 42.85% of males and 43.47% of females had vascular calcifications. Thoracic aortic calcification was more common than coronary artery calcification. Mean CACS and TACS scores were 91.6±6327.8 and 85.576205.5 respectively. Only 12.3% had diabetes mellitus whereas 93.8% had hypertension as comorbidity. Increasing age correlated with presence of vascular calcification (p-0.00). Calcium, phosphorus and iPTH levels did not correlate with presence of vascular calcification (p value 0.10, 0.81, 0.83 respectively). CONCLUSIONS: There is an increased prevalence of vascular calcification in ESRD patients as age increases. Larger scale longitudinal studies are needed for greater insight into the complex relationship of calcium, phosphorus, iPTH levels and vascular calcification.