P1391PROGRESSION OF CALCIFICATION AND ITS RISK FACTORS IN CHINESE DIALYSIS PATIENTS

Abstract

Abstract Background and Aims The China Dialysis Calcification Study (CDCS) aims to investigate prevalence and progression of vascular calcification (VC) as well as predictive values of VC in Chinese dialysis patients. This abstract reports VC progression and its risk factors during 4-year follow-up. Method The CDCS is a nationwide, multicenter observational study. 1497 dialysis patients from 24 centers in China were enrolled from 2014-2015 and continuously followed up for 4 years. Coronary artery calcification (CAC), abdominal aortic calcification (AAC) and cardiac valve calcification (CVC) were assessed at baseline and 4-year follow-up. CAC was assessed by Agatston score measured by electron beam computed tomography or multi-detector computed tomography. AAC was assessed by Kauppila score measured by plain lateral lumbar radiograph. CVC was measured by echocardiography. Progression was defined by comparing VC images at baseline with those at 4-year. When CAC/AAC scores at 4-year were greater than baseline, CAC/AAC were considered progressed; when there were more cardiac valves involved at 4-year than baseline, CVC was considered progressed. Logistic progression model was used to investigate the risk factors for calcification progression. Results 711 patients completed 4-year follow-up and 680 of them had calcification tests. Patients had the same type assessments (CAC, AAC or CVC) at both baseline and 4-year were included in analysis. At the 4-year follow-up, 89.4% (608/680) patients had at least one site vascular calcification (CAC, AAC or CVC), CAC affected the highest proportion of patients. Prevalence of CAC, AAC and CVC were 81.0% (517/638), 79.3% (310/391) and 45.6% (308/675), respectively. Progression of CAC was observed in 93.9% (368/392) patients with presence of baseline CAC, and 51.3% (123/240) patients without baseline CAC. CAC progression at 4-year follow-up was stratified by baseline CAC score (Figure1). Progression of AAC was observed in 96.5% (165/171) patients with presence of baseline AAC, and 63.8% (139/218) patients without baseline AAC. AAC progression at 4-year follow-up was stratified by baseline AAC score (Figure2). Progression of CVC from single to double cardiac valve calcification was observed in 33.3% (40/120) patients, and cardiac valve calcification occurred in 33.4% (162/485) patients without baseline CVC after 4-year follow-up. Multivariate logistic regression analysis results are showed in Figure3. Variables significantly increased the risk of calcification progression were baseline calcification score, abdominal obesity, hypertension, and calcium, phosphorous, iPTH during 4-year follow-up. Conclusion In the 4 years follow-up, progression of calcification is common among dialysis patient, and is associated with higher baseline severity, medical history and disease management.