Features of coronary calcification in patients receiving renal replacement therapy with program hemodialysis

Abstract

Objective: to study the features of coronary calcification in patients with chronic kidney disease receiving renal replacement therapy with program hemodialysis. Materials and methods: in the process of an open clinical trial, a group of patients (n = 43) with end-stage chronic kidney disease (23 women and 20 men) was formed. The average age of patients was 54±13 years, the median length of dialysis therapy was 11 [6; 16] months. All patients received renal replacement therapy with program hemodialysis. The procedures were carried out on artificial kidney devices according to the standard scheme 3 times a week for 4 hours. Patients underwent traditional clinical and laboratory examination. All patients were assessed for coronary calcification by multispiral computed tomography. On the Agatston scale, the severity of coronary calcification was assessed taking into account the density and area of calcium deposition. Results: on the results of multispiral computed tomography to determine the degree of calcification of the coronary arteries, we found that 48% of patients had low and minimal calcification, 16% — insignificant calcification, 36% — measured and pronounced calcification. When comparing laboratory parameters in the groups of patients with different calcification of the coronary arteries, the level of inorganic phosphorus (1,64±0,07 mmol/L) was significantly higher in patients with insignificant, moderate and severe calcification than in patients with minimal and low calcinosis (1,35±0,12 mmol/L) (p=0.04). There was a pronounced direct correlation between age and calcium index (r=0,52, p=0,0011). With an increase in dialysis experience, an increase in calcium index is noted (r = 0,14; p = 0,045). Conclusion: in 52% of patients with end-stage chronic kidney disease receiving renal replacement therapy with program hemodialysis, coronary calcification is determined from the results of multispiral computed tomography of the coronary arteries. Patients with moderate to severe coronary calcinosis have significantly higher levels of serum phosphorus compared to patients with minimal to low calcinosis. At the same time, the age of patients and the length of dialysis therapy affect the severity of coronary calcinosis