The link between bone and coronary calcifications in CKD-5 patients on haemodialysis

Gulay Asci, Ercan Ok, Recep Savas, Mehmet Ozkahya, Soner Duman, Huseyin Toz, Meral Kayikcioglu, Adam J. Branscum, Marie Claude Monier-Faugere, Johann Herberth, Hartmut H. Malluche

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Background: Vascular calcifications are frequent in Stage 5 chronic kidney disease (CKD-5) patients receiving haemodialysis. The current study was designed to evaluate the associations between bone turnover/volume and coronary artery calcifications (CAC).Methods. In 207 CKD-5 patients, bone biopsies, multislice computed tomography of the coronary arteries and blood drawings for relevant biochemical parameters were done. The large number of CKD-5 patients enrolled allowed separate evaluation of patients with CAC versus patients without CAC and adjustment for traditional and non-traditional risk factors for CAC.Results. When all patients were analysed, associations were found between CAC and bone turnover, bone volume, age, gender and dialysis vintage. When only patients with CAC were included, there was a U-shaped relationship between CAC and bone turnover, whilst the association with bone volume was lost. In these patients, the relationship of CAC with age, gender and dialysis vintage remained.Conclusions. Beyond the non-modifiable risk factors of age, gender and dialysis vintage, these data show that bone abnormalities of renal osteodystrophy amenable to treatment should be considered in the management of patients with CAC.

Original languageEnglish
Pages (from-to)1010-1015
Number of pages6
JournalNephrology Dialysis Transplantation
Volume26
Issue number3
DOIs
StatePublished - Mar 2011

Bibliographical note

Funding Information:
Acknowledgements. Fresenius Medical Care supported this study. FMC have not been involved in any way in the study design, data management or manuscript preparation. Data from this study were presented at the XLIV Congress of the European Renal Association–European Dialysis and Transplant Association; June 24 through 27, 2007; Barcelona, Spain. We thank Ebru Sevinc, MD; Fatih Kırcelli, MD; and Mumtaz Yilmaz, MD for the support in performing bone biopsies and Timur Kose for the statistical advice. The study was supported by the Dean’s Clinical Research Scholar Program, University of Kentucky, no. 1012112710 (to J.H.), by NIH RO1 DK080770-01 (to H.H.M.) and by the Kentucky Nephrology Research Trust (to M-C.M-F.). We thank Guodong Wang, MD, Richard Wheaton and Julia Van Willigen for their technical support.

Keywords

  • bone turnover
  • bone volume
  • coronary calcifications
  • dialysis
  • renal osteodystrophy

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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