P1245AORTIC ARCH CALCIFICATION AND PROGNOSIS IN HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims Aortic arch calcification (AAC) is associated with poor survival in dialysis patients, but long-term prognosis has not been examined well. Method In the present study, we investigated the prognostic impact of AAC among 321 chronic hemodialysis patients (211 males, 64±11 ages, dialysis history 10±8 years). ACC in chest X-ray was evaluated in 2012 and the patients were followed up for 7 years. The degree of AAC was classified into 4 categories as follows: Grade 0, no visible calcification; Grade 1, small spots of calcification or single thin calcification of the aortic knob; Grade 2, one or more areas of thick calcification; and Grade 3, circular calcification of the aortic knob. Results Calcification gravity was Grade 0 in 88 patients (27%), Grade 1 in 145 (45%), Grade 2 in 54 (17%) and Grade 3 in 34 (11%). All-cause mortality was significantly worse in patients with higher AAC grade (Grade 0: 19% (n=17), Grade 1: 35% (n=51), Grade 2: 46% (n=25), Grade 3: 71% (n=24); p < 0.0001). Univariate analysis showed AAC grade, age, cardiothoracic ratio, ischemic heart disease, cerebral vascular disease, albumin, hemoglobin, C-reactive protein and use of non-Ca phosphorus binders were significantly associated with all-cause mortality. In multivariate analysis, Grade 3 AAC, age and ischemic heart disease were independent risk factors for all-cause mortality.(Figure) Conclusion In our dialysis patients, higher gravity of AAC was independently associated with all-cause mortality. Gravity of AAC in chest X-ray is useful to predict prognosis of dialysis patients.