Impact of longer-term phosphorus control on aortic arch calcification in hemodialysis patients

Abstract

[Objectives] This study aimed to evaluate the relationships between the area under the curve (AUC) of monthly serum phosphorus levels (P) of＞4.5 mg/dL for 6 months and the following：monthly averaged P for the 6- month period, one-time P, chest X-ray-evaluated aortic arch calcification (AoAC), and echocardiography results. [Subjects] The subjects were 109 patients who received maintenance hemodialysis (HD) for ≥6 months. [Methods] ①We evaluated the correlation among the AUC, averaged P, and one-time P. ②We divided the HD patients into two groups based on the median AoAC and compared their P, cardiac function, and other factors. ③We grouped the patients into three groups according to their AUC and compared their AoAC, cardiac function, and other factors. [Results] ①The AUC was strongly correlated with the averaged P. ②The AUC and averaged P of the HD patients with higher AoAC values were significantly higher. ③The patients with the highest AUC values had significantly higher AoAC and E/e´ values. [Conclusions] The AoAC values of the HD patients with higher AUC values and averaged P were significantly increased, and their cardiac diastolic functions were decreased. As the P of HD patients fluctuate according to their diet and medication adherence, the AUC, is a more suitable measure than one-time P. However, the averaged P, which is strongly correlated with the AUC, is not inferior to the AUC.