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Title Coronary Calcification Score in a Maintenance Hemodialysis Population in Singapore
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Type Oral Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Dialysis: Haemodialysis |
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Main Author Jia Neng Tan1 |
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Presenting Author Jia Neng Tan1 |
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Co-Author Sabrina Haroon1 Bee Choo Tai 1 Lynette Teo1 Emily Yeo1 Lieng Hsi Ling 1 Srinivas Subramanian 1 Priyanka Khatri1 Sanmay Low1 Horng Ruey Chua1 Weng Kin Wong1 Jimmy Boon Wee Teo1 Titus Lau |
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Department / Institution / Country Medicine / National University Health System / Singapore1 |
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Abstract Content: Introduction, Method, Result, Conclusion INTRODUCTION End Stage Kidney Disease (ESKD) patients are often plagued with multiple co-morbidities. Coronary artery disease remains one of the top causes of death and vascular calcification is a predictor of all-cause mortality in hemodialysis (HD) patients. Coronary artery calcium (CAC) is a non-invasive means of evaluating burden of calcification. In this study, we aim to identify associations linked to a higher CAC score that might be unique to an Asian population. METHODS Our study is a single center prospective study of ESKD patients on HD. 216 patients were recruited and underwent CAC scoring. Patients were ≥ 45 years and < 80 years of age. At recruitment, vintage on HD ≥ 12 months with CAC score of ≥ 30 and life expectancy of ≥ 18 months. RESULTS Median age of the population was 61 years (range 24, 80), with equal gender distribution. 51% were Chinese, 44% Malays and 5% Indians. 62.5% were diabetics and 28% were smokers. Median vintage of dialysis was 3 years (range 1, 28). Factors associated with higher CAC scores (on univariate regression analysis) were: older age (p-value 0.018), male gender (p-value 0.005), longer dialysis vintage (p-value 0.006), and presence of hypertension (p-value 0.022). Notably, diabetes was not associated with higher CAC scores. Patients on non-calcium based phosphate binders had a lower CAC score of log5.97 in compared to those on calcium based phosphate binders - CAC score: log6.25. Higher PTH values correlated with higher CAC scores. However, these variables studied were not statistically significant. CONCLUSION Identification of hemodialysis patients with high risk for vascular calcification is of utmost importance given the heavy burden of vascular disease. It is interesting to note that traditional risk factors like PTH, use of different of phosphate binders and smoking have not featured significantly.
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