The effects of dialysis modalities on the progression of coronary artery calcification in dialysis patients

Abstract

Objective Hemodialysis (HD) tend to have more hemodynamic changes than peritoneal dialysis (PD), which aggravates inflammation and oxidative stress. Whether HD and PD have different effects on the progression of vascular calcification? Therefore, we produced a study to explore the relationship of dialysis modalities and coronary artery calcification (CAC) progression. Methods This was a prospective cohort study. CT scans were performed at enrollment and 2 years later for each patient. Demographic and clinical data were collected. Tobit regression was used to compare delta CAC score between HD and PD patients. Results (1) 155 patients were enrolled, including 69 HD and 86 PD patients. (2) The baseline CAC scores were 97 (1, 744) in HD and 95 (0, 324) in PD; the follow-up CAC scores were 343 (6, 1379) in HD and 293 (18, 997) in PD. There were no significant differences in baseline, follow-up and delta CAC scores between 2 groups (P>0.05). (3) In Tobit regression, after adjusted for variables, there was no significant difference of CAC progression in HD and PD groups (P>0.05). (4) Logistic regression showed that older patients with diabetes and higher time-averaged serum phosphate (P) had faster progression of CAC (P<0.05), but HD wasn’t associated with faster CAC progression comparing with PD (P=0.091). Conclusions There was no evidence that different modalities have different effect on CAC progression. Older, DM and higher time-averaged P were associated with fast CAC progression.