Prospective Comparison on the Progression of Abdominal Aortic Calcification According to Dialysis Modality in End-Stage Renal Disease Patients

초록

Background: In end-stage renal disease patients on dialysis, the prevalence, degree and progression of arterial calcifications are greater than in general population. However, there have been few reports whether the progression of abdominal aortic calcifications (AAC) is different or not according to dialysis modality. The purpose of this study was to compare the incidence of AAC progression between hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: HD and PD patients who had been on dialysis for > 3 years were included in this observational, prospective 1-year study. Laboratory data of previous 2 years were reviewed as baseline data. AAC was assessed with plain lateral lumbar spine x-ray using anterior-posterior abdominal aorta calcification score (which was developed by Kauppila LI et al) at the baseline and 12 month. AAC progression was defined as the increase in the length of linear calcification or new appearance of calcification. Among 125 (51 HD and 74 PD) patients who were included at baseline, the data of 99 (40 HD and 59 PD) patients who fulfilled the study were assessed. Results:Thirty one patients were progressed (Group 1) and 68 were unchanged (Group 2) in AAC. In group 1, 11 were HD and 20 were PD patients. There was no difference in the incidence of AAC progression between HD and PD (27.5 vs. 33.9%). In group 1, the AAC scores at baseline were 7.9+5.8 in HD and 8.5+6.0 in PD and, after 1 year, 10.2+5.7 in HD and 10.7+6.5 in PD, respectively. In group 2, AAC scores at baseline and after 1 year were unchanged in HD (6.3+7.0) and PD (6.6+7.2). There were no differences in the mean laboratory values of previous 2 years, the percentages of diabetes (51.6 vs. 38.2%), male (32.3 vs. 41.2%), the presence of residual renal function (32.3 vs. 42.6%) and the presence of coronary artery disease (12.9 vs. 5.9%) between group 1 and 2. Conclusions: Dialysis modality seems not to affect differently on the progression of abdominal aortic calcifica