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. 2023 Sep 24;59(10):1706.
doi: 10.3390/medicina59101706.

Intra-Cranial Arterial Calcifications in Hemodialysis Patients

Feda Fanadka  1 , Ilan Rozenberg  2   3 , Naomi Nacasch  2   3 , Yael Einbinder  2   3 , Sydney Benchetrit  2   3 , Ori Wand  4 , Tammy Hod  3   5 , Keren Cohen-Hagai  2   3
Affiliations

Intra-Cranial Arterial Calcifications in Hemodialysis Patients

Feda Fanadka et al. Medicina (Kaunas). .

Abstract

Background and objectives: Vascular calcification is an integral part of atherosclerosis and has been reported to be an independent risk factor for cardiovascular diSsease. Intra Cranial Arterial Calcifications (ICAC) in maintenance hemodialysis (MHD) is highly prevalent. Materials and Methods: The aim of this retrospective study was to assess the predictors and outcomes of ICAC in MHD patients compared to a control group without kidney disease. A blinded neuroradiologist graded ICAC in brain imaging (computerized tomography) of MHD patients. Age- and sex-matched patients with normal kidney function served as the control group. Results: A total of 280 patients were included in the cohort; 140 of them were MHD patients with a mean ICAC score of 2.3 ± 0.2 versus a mean ICAC score of 1.4 ± 0.2 in the control group (p < 0.01). More than 90% of hemodialysis patients in our study had some degree of ICAC. Lower albumin and higher phosphorus and CRP levels were associated with increased ICACs. The multivariate analysis model for predictors of 1-year mortality demonstrated an increased odds ratio for mortality as the ICAC score increased. Conclusions: ICAC is very prevalent among MHD patients and results not simply from passive deposition of calcium and phosphate but rather from complex and active processes involving inflammation and structural changes in blood vessels. ICAC independently predicted all-cause mortality and may help with risk stratification of this high-risk population.

Keywords: arterial calcification; atherosclerosis; end stage kidney disease; hemodialysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of intra-cranial calcifications among the study population.
Figure 2
Figure 2
Intra Cranial Arterial calcifications (ICAC) as a function of age. (Left): correlation between age and intracranial calcifications (ICAC) score in dialysis patients; (Right): control patients. p < 0.01.
Figure 3
Figure 3
Kaplan–Meier survival curves of dialysis patients according to ICAC. Overall mortality over time was significantly higher for hemodialysis patients with higher ICAC scores, p < 0.01.
See this image and copyright information in PMC

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