Kidney Week

Abstract: TH-PO254

Coronary Artery Calcification Is Associated with Low Kt/Vurea and Extracellular Fluid Excess in Patients on Hemodialysis

Session Information

• Hemodialysis: Volume, Metabolic Complications, Clinical Outcomes
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Sonoo Mizuiri,

• Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Yoshiko Nishizawa,

• Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Toshiki Doi,

• Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Aiko Okubo,

• Morii, Kenichi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Kenichi Morii,

• Yamashita, Kazuomi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Kazuomi Yamashita,

• Karasuda, Kazuyoshi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Kazuyoshi Karasuda,

• Usui, Koji, Iryo Hojin Ichiyokai Ichiyokai Clinic, Hiroshima, Japan, Japan

Koji Usui,

• Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan

Kenichiro Shigemoto,

• Masaki, Takao, Hiroshima University Hospital, Hiroshima, Japan

Takao Masaki,

Background

An insufficient dialysis dose and extracellular fluid excess are independent predictors of cardiovascular morbidity in patients on hemodialysis. We studied the associations among coronary artery calcification, Kt/Vurea, and body composition in patients on hemodialysis.

Methods

The Agatston coronary artery calcium score (CACS), postdialysis body composition using bioelectrical impedance device, and clinical data including Kt/Vurea and predialysis β2-microglobulin (β2M) at enrollment, were assessed in patients on hemodialysis. The patients were classified into two groups according to a CACS ≥400 or a CACS <400, and intergroup differences were analyzed using the Wilcoxon test or the x² test, as appropriate. Linear regression analyses were performed to identify the risk factors for CACS.

Results

In all patients (n=324), age, the dialysis duration, the diabetes prevalence, and the CACS were 69±12 years, 116±105 months, 133/324 (41.0%), and 763 (155–2491), respectively. Patients with a CACS ≥400 (n=208) were older (72±11 vs. 66±14 years), had a longer dialysis duration (123±109 vs. 104±98 months), had a higher diabetes prevalence (46.6 vs. 31.0 %), serum phosphate concentrations (5.5±1.5 vs. 5.1±1.3 mg/dL), extracellular water/total body water (ECW/TBW) (0.49±0.03 vs. 0.47±0.03), and overhydration (OH) (1.2±1.5 vs. 0.7±1.1 L), and had lower Kt/Vurea (1.43±0.24 vs. 1.64±0.54) than patients with a CACS <400 (n=116), (P<0.05). Serum albumin, magnesium, C-reactive protein, and albumin-adjusted calcium levels were not significantly different between the two groups. In simple linear regression analyses, age, dialysis duration, diabetes, smoking, serum phosphate, ECW/TBW, and OH were significantly associated with the CACS (all P<0.05), and β2M showed marginal significance (P=0.06). Multiple linear regression analysis adjusted for age, dialysis duration, and diabetes showed that Kt/Vurea, β2M, and ECW/TBW were risk factors for CACS (all P<0.05). After additional adjustment for serum phosphate and smoking, only Kt/Vurea (β: −0.16) and ECW/TBW (β: 0.12) were significant predictors for CACS (both P<0.05).

Conclusion

Lower Kt/Vurea and extracellular fluid excess are independently associated with coronary artery calcification in patients on hemodialysis.

Funding

• Private Foundation Support