Pelvic Artery Calcification Score Is a Marker of Vascular Calcification in Male Hemodialysis Patients

Abstract

Patients who undergo hemodialysis often suffer from cardiovascular disease (CVD), and evaluation of coronary artery calcification is extremely important. These evaluations are typically conducted using a noninvasive method including electron beam computed tomography (CT) or multi-detector CT, and the Agatston method to calculate the coronary artery calcification score (CACS). However, it is difficult to use for patients undergoing dialysis. Because patients undergoing dialysis is too strong in coronary artery calcification, and results become incorrect. Therefore, we were looking for a calcified evaluation place peculiar to a patients undergoing dialysis. We obtained pelvic artery calcification scores (PACS) using a 64-row multi-slice CT to assess the presence of calcification within a triangular space bordered by bordered by osseous structure. We used the Agatston method to calculate PACS. We compared male patients undergoing dialysis with male patients with normal renal function. Patients undergoing hemodialysis had a significantly higher incidence of pelvic artery calcification than normal controls (79.7% vs. 5.5%). In the dialysis group, CACS was 1660.2 (0-9056.1), and PACS was 48.8 (0-2943.1). We found a correlation between PACS and CACS and between PACS and dialysis period. We found penile artery calcification in male patients undergoing hemodialysis was more than normal controls, and it was possible to quantify PACS using the Agatston method. This study suggested the possibility that PACS became the vascular calcification evaluation method of the hemodialysis patient.

Association of cause of uremia with degree of iliac artery calcification

“…They found that calcification increases with time on dialysis. 13 A recent study by Marcuzzi et al is comparable with our study. Those authors also used Agatston score to evaluate potential kidney recipients' level of iliac artery calcification.…”

“…They looked at calcification in the pelvic arteries in a well‐defined triangle, but did not include the iliac arteries. They found that calcification increases with time on dialysis 13 …”

Cardiovascular risk assessment and coronary artery calcification burden in asymptomatic patients in the initial years of hemodialysis

“…One possible solution could be intima media thickness (IMT) measurement of carotid and peripheral arterial vessels, as it enables an easy diagnosis of early‐stage atherosclerosis 8 . Lately, an increasing interest has been noted regarding the use of coronary artery calcium score (CACS) as a reliable predictor of future CV events in patients with declining renal function, especially in those receiving chronic HD 1,8–11 . However, to the best of our knowledge, the specific tool for CV risk assessment has not yet been proposed by any international guideline concerning the dialysis population.…”

Briefly Noted

“…Multi‐slice CT of the pelvic area found arterial calcification (mainly in the penile arteries) of 80% of 53 HD patients with erectile dysfunction; coronary artery calcification was present in 98% of these patients …”