FP600ARTERIAL CALCIFICATION AND OSTEOPOROSIS IN END-STAGE RENAL DISEASE PATIENTS WHO ARE UNDERGOING HEMODIALYSIS

Abstract

Introduction and Aims: There are some evidence that atherosclerosis is associated with bone disease in patients with end-stage renal disease, contributing to their increased mortality and morbidity. The study purpose was to assess the relationship between osteoporosis and arterial disordes like calcification and stiffness in chronic hemodialysis (HD) patients. The association between mineral and bone disorders and vascular disease was also tested. Ultrasound examinations were used because they are accessible, reliable and non-invasive. Method(s): This cross-sectional, analytical study has been realized on a cohort of 87 end-stage renal disease patients, randomly selected. All were on conventional HD therapy. Inclusion criteria: prevalent HD patients, age > 18 years. Exclusion criteria: neoplasm, severe infections, parathyroidectomy, previous bone disease or renal transplant. The data regarding demographical and clinical characteristics, including treatments for mineral and cardiovascular complications, were recorded. We calculated body mass index (BMI), mean blood pressure (MBP), and pulse pressure, ankle-arm index. Serum mineral markers levels were measured. Vascular ultrasound was performed to detect vascular calcification in carotid and femoral arteries. Arterial intimal calcification (AIC) and arterial medial calcification (AMC) were registered and quantified as a score. Bone mineral density was assessed by calcaneus quantitative ultrasound and the specific parameters broadband ultrasound attenuation (BUA), speed of sound (SOS), stiffness index (STI), T-Score and Z-Score were registered. The statistical analyses performed in order to reach the study goal included T-test, Chi-square, Fisher exact, linear regression and binary logistic regression. Result(s): Among all patients, 67.8% had a T-score below-2.5 SD. The group with AIC had a lower BUA (p=0.01) and T-score (p=0.002) than the patients without AIC. There were no associations between any BMD indices and AMC, pulse pressure or ankle-arm index. BMD variables were introduced in logistic regression using AIC as dependent variable. The model was significant (p=0.002). Only T-score remained in the equation as being predictive for AIC (p=0.003; OR=0.407, 95%CI = 0.223-0.741). Conclusion(s): The presence of uremic osteoporosis can be considered a predictive factor for the occurence of the calcified atherosclerotic plaques in patients with end-stage renal disease undergoing chronic hemodialysis.