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

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 > or =5, VC score of the hands and pelvis > or =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.