Improved Assessment of Aortic Calcification in Japanese Patients Undergoing Maintenance Hemodialysis

Objective Vascular calcification is a feature of arteriosclerosis and in hemodialysis (HD) patients it may be severe, even at a relatively young age, and is closely related to the overall prognosis. We used the aortic calcification area index (ACAI), derived from the aortic calcification index (ACI), to evaluate and analyze the risk factors for abdominal aortic calcification in HD patients. Patients and Methods Subjects comprised 137 patients on maintenance HD. ACAI was measured on abdominal plain computed tomography: 10 slices of the abdominal aorta were obtained at 1-cm intervals from the bifurcation of the common iliac artery and the area of the aortic cross-section and calcification was measured using image software. The calcification area was divided by the cross-sectional area and expressed as a percentage (%). The mean value for the 10 slices was also calculated. Patients were divided into 2 groups according to ACAI being lower or higher than the mean value and the risk factors in each group were compared by multivariate analysis. Results Group comparison showed significant differences in age, systolic blood pressure, serum calcium, and lipoprotein(a). On multiple regression analysis, age, systolic blood pressure, and serum calcium were independent risk factors. On logistic regression analysis, age, duration of dialysis, systolic blood pressure, and serum calcium were independent risk factors. Conclusion Risk factors for abdominal aortic calcification in HD patients include age, systolic blood pressure, and serum calcium, according to ACAI evaluation. The ACAI was accurate and useful for evaluating abdominal calcification.