Assessment of Arterial Stiffening and Vascular Calcifications in End‐Stage Renal Disease Patients

Abstract

Background and Objective: Epidemiological and clinical studies have shown that vascular calcification and arterial vascular stiffness are associated with all-cause and cardiovascular (CV) mortality in the general populations and end-stage renal disease (ESRD) patients. The objective of this study was the assessment of arterial stiffness and vascular calcification in ESRD patients in Sohag University Hospital. Patients and Methods: In this cross-sectional descriptive study, 100 patients with ESRD (63 males and 37 females) were included. The patients were on regular hemodialysis (HD) for 65.18 ± 50.25 months. Arterial stiffness was measured by brachial pulse pressure (PP). A simple vascular calcification score (SVCS) based on plain radiographic films of pelvis and hands was used for assessment of vascular calcification. The patients undergoing clinical evaluation and serum calcium, phosphorus and parathyroid hormone (PTH) were obtained. Results: PP > 70 mmHg was observed in 24 patients (24%) and vascular calcifications were detected in 50 patients (50%). SVCS ≥ 3 was observed in 36 patients (36%) and 10 patients (10%) had both SVCS ≥ 3 and PP > 70 mmHg. PP > 70 was significantly associated with presence of vascular disease (odds ratio; 5, 95% CI = 1.56 - 16.01; P = 0.007). In multivariate analysis, PP > 70 was independently associated with elevated systolic blood pressure (odds ratio; 1.34, 95% CI = 1.11 - 1.6; P = 0.002) and serum PTH (odds ratio; 1.004, 95% CI = 1 - 1.008; P = 0.03). SVCS ≥ 3 was association with age (odds ratio; 1.05, 95% CI = 1.02 - 1.09; P = 0.003) and presence of vascular disease (odds ratio; 3.19, 95% CI = 1.3 - 7.85; P = 0.01). Elevated systolic blood pressure was independently associated with SVCS ≥ 3 (odds ratio; 1.08, 95% CI = 1.03 - 1.14; P = 0.002). Conclusion: Arterial stiffness and vascular calcifications are common in patients with ESRD on regular hemodialysis. PP and SVCS are simple and inexpensive methods in assessment of vascular calcifications and arterial stiffness in hemodialysis patients. PP and SVCS may provide important information that may guide the management of these patients.