Abdominal aortic calcification in dialysis patients: results

Abstract
Background. Patients with chronic kidney disease stage 5
have a high prevalence of vascular calcification, but the
specific anatomical distribution and severity of abdominal
aortic calcification (AAC), in contrast to coronary calcification,
is less well documented. AAC may be recorded
using plain radiographs. The present report is an analysis
of baseline data on AAC in patients enrolled in the CORD
(Calcification Outcome in Renal Disease) study.
Methods. A total of 47 centres in six European countries
participated in this cross-sectional study. Inclusion criteria
were age ≥18 years and duration of dialysis ≥3 months.
Lateral lumbar radiography of the abdominal aortawas used
to determine the overall AAC score, which is related to the
severity of calcific deposits at lumbar vertebral segments
L1–L4. The reliability of the method was tested by double
reading of 64 radiographs (coefficient of correlation 0.9).
Results. A lateral lumbar radiograph was obtained in
933 patients. Calcification (AAC score ≥ 1) was present
in 81% of the patients; its severity increased significantly
from L1 to L4 (P < 0.0001) and affected all of these segments
in 51% of patients. Independent predictors for the
presence and severity of calcification were age (odds ratio
[OR] 1.103/year; P < 0.0001), duration of dialysis (OR
1.110/year; P = 0.002) and history of cardiovascular disease
(OR 3.247; P < 0.0001).
Conclusions. AAC detected by lateral lumbar radiograph is
associated with several risk factors of uraemic calcification.
This semi-quantitative method is more widely available and
less expensive than the current procedures for studying
calcification and could formpart of a pre-transplantworkup
and cardiovascular risk stratification.