Association of Thoracic Aortic Calcification with All-Cause Mortality in Maintenance Hemodialysis Patients: A Prospective Cohort Study

Abstract

Objective

Cardiovascular disease (CVD) is the leading cause of mortality in patients with end-stage renal disease (ESRD) undergoing maintenance dialysis. To further clarify this critical relationship, we conducted a prospective study to evaluate the prognostic significance of calcification in different segments of the thoracic aorta for all-cause mortality in this patient population.

Methods

This prospective study enrolled stable adult patients who were undergoing maintenance hemodialysis (MHD) at our center between July 2019 and December 2020 and who had available chest X-rays or computed tomography (CT) scans. Thoracic aortic calcification (TAC) was assessed via chest CT or X-ray imaging. Cox proportional hazards models and Kaplan‒Meier curves were used to describe the risk factors for mortality.

Results

At a mean follow-up of 3.95 years, 18 of 62 patients had died. Cox proportional hazards regression models demonstrated that elevated systolic blood pressure (HR 1.029), aortic arch calcification (AAC) (HR 1.104), and descending thoracic aortic calcification (DTAC) (HR 1.066) were independent risk factors for all-cause mortality in patients with MHD (all P < 0.05). Additionally, the presence of severe DTAC or severe AAC emerged as an independent risk factor for death in this patient population (log-rank test, P < 0.05).

Conclusion

AAC and DTAC are important predictors of all-cause mortality among patients undergoing maintenance hemodialysis.

Keywords

Maintenance hemodialysis / Mortality / Thoracic aortic calcification / Aortic arch calcification / Cardiovascular disease

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Funding

Nephropathy Medical Development Research Project of China Primary Health Care Foundation(SO.20220217SD)

RIGHTS & PERMISSIONS

The Author(s), under exclusive licence to the Huazhong University of Science and Technology