Comparison of Vascular Calcification Scores on Plain Radiographs to Predict Coronary Artery Disease According to Dialysis Modality

Korean Journal of Nephrology 2011;30(3):292-301.

Joon Mo Kim, M.D.1, Jung Min Kim, M.D.1, Su Mi Lee, M.D.1, Seung Hee Ryu, M.D.1, Ki Hyun Kim, M.D.1, Seong Eun Kim, M.D.1, Young Ki Son, M.D.1, Jin Yeong Han, M.D.2, Dong Ho Ha, M.D.3 and Won Suk An, M.D.1, 4

Department of Internal Medicine¹
Department of Laboratory Medicine²
Department of Radiology³
Medical Science Research Center⁴
Dong-A University College of Medicine, Busan, Republic of Korea

원저 : Comparison of Vascular Calcification Scores on Plain Radiographs to Predict Coronary Artery Disease According to Dialysis Modality

Department of Internal Medicine1, Department of Laboratory Medicine2, Department of Radiology3, Medical Science Research Center4, Dong-A University College of Medicine, Busan, Republic of Korea

Abstract

Purpose: Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) in hemodialysis (HD) patients. However, there is no report comparing VC scores on plain radiographic films according to dialysis modality. We hypothesized that there are some differences of VC scores on plain radiographs for the assessment of CAD according to dialysis modality. Methods: We recruited 78 peritoneal dialysis (PD) patients and compared to 61 HD patients. We defined significant VC as any one finding among the abdominal aortic calcification (AAC) score ≥5, VC score of the hands and pelvis ≥3, or medial artery calcification of the feet on plain radiographs. Results: The prevalence of CAD and significant VC were not different according to dialysis modality. Every VC score on the plain radiographs was highly correlated with each other, but VC evaluation on plain radiographs by single method overlooked nearly 30% of other significant VC sites in PD and HD patients. AAC score was most useful method for the prediction of CAD as a single VC scoring method. There was no association between VC of the feet and CAD in PD patients. Lower high density lipoprotein cholesterol was associated with significant VC on plain radiograph in PD patients. Conclusion: Significant VC formation on plain radiographs was not different according to dialysis modality. It is helpful to check several plain radiographs for the decision of CAD evaluation and not overlooking significant VC in both HD and PD patients.

Key Words: Vascular calcification, Radiography, Coronary artery disease, Dialysis