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Multicenter Study
. 2011 Feb;6(2):303-10.
doi: 10.2215/CJN.04290510. Epub 2010 Oct 7.

Large artery calcification on dialysis patients is located in the intima and related to atherosclerosis

Blai Coll  1 , Angels Betriu, Montserrat Martínez-Alonso, Maria Luisa Amoedo, Maria Vittoria Arcidiacono, Merce Borras, Jose Manuel Valdivielso, Elvira Fernández
Affiliations
Multicenter Study

Large artery calcification on dialysis patients is located in the intima and related to atherosclerosis

Blai Coll et al. Clin J Am Soc Nephrol. 2011 Feb.

Abstract

Background and objectives: Vascular calcification (VC) has a significant effect in cardiovascular diseases on dialysis patients. However, VC is assessed with x-ray-based techniques, which do not inform about calcium localization (intima, media, atherosclerosis-related). The aim of this work is to study VC and its related factors using arterial ultrasound to report the exact location of calcium.

Design, setting, participants, & measurements: This was an observational, cross-sectional, case-control study that included 232 patients in dialysis and 208 age- and sex-matched controls with normal kidney function. Demographic data and laboratory values were collated. Carotid, femoral, and brachial ultrasounds were performed to assess VC and atherosclerosis burden using a standardized protocol.

Results: Cardiovascular risk factors were predominantly found in controls, although the burden of atherosclerosis was higher in the dialysis group. VC was significantly more prevalent in the group of patients on dialysis than control subjects, and in both groups the most prevalent pattern of VC was linear calcification located in the intima of the artery wall. Age and undergoing dialysis (with or without previous cardiovascular diseases) were positively and significantly associated with linear calcification. Conversely, the absence of atherosclerosis and low levels of C-reactive protein and phosphorus significantly impeded the development of linear calcification.

Conclusions: VC in large, conduit arteries is more prevalent in patients on dialysis than controls and is predominantly located in a linear fashion in the intima of the arteries.

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Figures

Figure 1.
Figure 1.
Ultrasound exams of different types of VC. (A) Type V atheroma plaque (white arrow) with acoustic shadowing because of plaque calcification (asterisk). (B) Linear hyperechogenicity located in the lumen-intima interphase (white arrow). (C) Linear hyperechogenicity located in the media space (white arrow).
See this image and copyright information in PMC

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