Calcinosis of abdominal aorta in chronic kidney disease patients, not receiving renal replacement therapy
- Authors: Volkov MM1, Smirnov AV1, Degtereva OA1, Kirillova EV1, Gordeeva LA1, Volkov MM1, Smirnov AV1, Degtereva OA1, Kirillova EV1, Gordeeva LA1
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Affiliations:
- Issue: No 2 (2010)
- Pages: 28-31
- Section: Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/245845
- ID: 245845
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Abstract
Purpose. Our study was aimed to determine the frequency of calcification of the abdominal aorta (CAA) and associated factors in patients with 1-5 stages of chronic kidney disease (CKD), not receiving renal replacement therapy.
Material and methods. The study included 149 patients (43% men) with 1-5 stages CKD, mean age 55.6 ± 13.9 years. Diabetic nephropathy was diagnosed in 59.1% of patients, chronic glomerulonephritis - in 20.8%, other diseases - in 20.1%. In addition to the routine clinical and laboratory tests, level of "intact" parathyroid hormone (PTH) was measured, 24-hour monitoring ECG and blood pressure (BP), echocardiography were performed. We also determined the thickness of the intima-media complex (IMT) of carotid arteries, forearm bone mineral density, and thickness of cortical layers of 2nd metacarpal bone, cortico-diaphyseal index, and the overall length of calcinates of abdominal aorta by X-ray in all patients.
Results. CAA was detected in 38.9% of patients. The most common comorbid conditions were coronary artery disease, heart failure as well as diabetes mellitus. CAA was more significant in elderly patients with greater IMT, higher level of blood pressure and low glomerular filtration rate (GFR), higher levels of PTH, phosphate, calcium-phosphate product, with less thickness of cortical layer of 2nd metacarpal bone and a low cortico-diaphyseal index. Patients with CAA have large atrial size, greater left ventricular hypertrophy, and often have calcification and stenosis of the aortic and mitral valves. According to multivariate statistical methods, severity of CAA was linked to the level of alkaline phosphatase and systolic blood pressure regardless of the patients' age, and the presence of CAA - with pulse BP and cortico-diaphyseal index.
Conclusion. Severity of CAA in patients with 1-5 stage CKD is predominantly related with the severity of atherosclerosis and its risk factors, and in less extent - with violations of mineral metabolism. CAA is associated with calcification of the heart valves and violation of intracardiac hemodynamics. We first found an association of CAA with severity of osteoporosis.
Material and methods. The study included 149 patients (43% men) with 1-5 stages CKD, mean age 55.6 ± 13.9 years. Diabetic nephropathy was diagnosed in 59.1% of patients, chronic glomerulonephritis - in 20.8%, other diseases - in 20.1%. In addition to the routine clinical and laboratory tests, level of "intact" parathyroid hormone (PTH) was measured, 24-hour monitoring ECG and blood pressure (BP), echocardiography were performed. We also determined the thickness of the intima-media complex (IMT) of carotid arteries, forearm bone mineral density, and thickness of cortical layers of 2nd metacarpal bone, cortico-diaphyseal index, and the overall length of calcinates of abdominal aorta by X-ray in all patients.
Results. CAA was detected in 38.9% of patients. The most common comorbid conditions were coronary artery disease, heart failure as well as diabetes mellitus. CAA was more significant in elderly patients with greater IMT, higher level of blood pressure and low glomerular filtration rate (GFR), higher levels of PTH, phosphate, calcium-phosphate product, with less thickness of cortical layer of 2nd metacarpal bone and a low cortico-diaphyseal index. Patients with CAA have large atrial size, greater left ventricular hypertrophy, and often have calcification and stenosis of the aortic and mitral valves. According to multivariate statistical methods, severity of CAA was linked to the level of alkaline phosphatase and systolic blood pressure regardless of the patients' age, and the presence of CAA - with pulse BP and cortico-diaphyseal index.
Conclusion. Severity of CAA in patients with 1-5 stage CKD is predominantly related with the severity of atherosclerosis and its risk factors, and in less extent - with violations of mineral metabolism. CAA is associated with calcification of the heart valves and violation of intracardiac hemodynamics. We first found an association of CAA with severity of osteoporosis.
Keywords
About the authors
M M Volkov
A V Smirnov
O A Degtereva
E V Kirillova
L A Gordeeva
M M Volkov
A V Smirnov
O A Degtereva
E V Kirillova
L A Gordeeva
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