Abstract
Aortic calcification is one of the most common features in long-term hemodialysis patients due to poor regulation of calcium. Aortic calcification can be evaluated semi-quantitatively on CT using the aortic calcification index (ACI). We reviewed the progression of aortic calcification over 4 years using ΔACI. In addition, several factors that participate in calcium metabolism, such as Ca×Pi products and PTH, were compared with ACI or ΔACI. Furthermore, we examined the correlation between ACI and the ankle pressure index (API) and/or ST-change of ECG.
The subjects were 50 patients maintained on hemodialysis. ACI was measured over 4 years, between 1991 and 1995. ACI increased progressively with high significance as follows; 10.3±12.4 in 1991, 158±152 in 1993 and 24.8±19.8 in 1995 (p<0.0001). According to the serum level of HS-PTH, all cases were classified into 3 sub-patient groups, the hypoparathyroidism, normoarathyroidism and hyerparathyroidism groups, and ACI was analyzed in each group. Although no significant intergroup difference in ACI ('93) was found, patients in the hypoparathyroidism group demonstrated a significantly higher ΔACI ('93-'95) than that in other groups. In addition, API was 0.96±0.09 and was negatively correlated to ΔACI (r=-0.456, p<0.05). In comparison with the ST-change on ECG, patients who exhibited a ST-change showed slightly higher ΔACI values (n. s.).
In conclusion, we failed to confirm the effect of Ca×Pi products on ACI, but our findings suggested that in some patients, such as those with hypoparathyroidis, aortic calcification may be accelerated.
