Assessment of stenosis and calcification of coronary vessels using coronary angiography in chronic dialysis patients

Abstract

We investigated stenosis and calcification of coronary vessels on the basis of coronary angiogram findings in uremic patients maintained on kidney replacement therapy. The coronary artery severity index (number of affected vessels) and calcification score were assessed in 14 uremic patients suspected of having coronary artery disease because of their clinical symptoms and ECG findings. The uremic subjects consisted of 8 hemodialysis patients (HD group) and 6 continuous ambulatory peritoneal dialysis patients (CAPD group). Fourteen non-uremic subjects who underwent coronary angiography served as controls. The mean of age in the uremic group (52.1±9.0 years) was not significantly different from that in the control group (57.9±7.8 years).
The calcification score (19.3) of the dialysis patients was significantly higher (p<0.002) than that (5.3) of the control patients. The calcification score was 20.8 in the HD group and 17.3 in the CAPD group, and no significant difference was observed between these two groups on different dialysis modalities. Nor was there any significant difference between the severity index of the dialysis group and the control group. Calcification scores were significantly correlated with duration of dialysis (r=0.62, p<0.03), but not with the severity index or age of the uremic patients.
These findings indicate that duration of dialysis is a major risk factor for coronary calcification in dialysis patients, but not age or severity index.