AORTIC ARCH CALCIFICATION IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract

Introduction. Vascular calcification is an independent risk factor related to cardiovascular mortality in CKD patients. Advanced aortic arch calcification assessed by semi-quantitative estimation on posteroanterior chest X-ray is a strong independent predictor of cardiovascular events in CKD and non-CKD patients, beyond traditional risk factors. An association between aortic arch calcification and hypertension has been previously reported however, the presence of CKD has not recorded in most studies. The aim of our study was to identify risk factors related to aortic arch calcification in hypertensive CKD patients. Material and method. A retrospective observational study on 63 hypertensive patients with CKD stages G2 to G4, that had a posteroanterior chest X ray available was conducted. The study population was divided into 2 groups according to presence or absence of aortic arch calcification on chest X-rays. Chest X-ray identified 43 patients with aortic arch calcification. Laboratory data were recorded for every individual simultaneously with the following comorbidities: coronary artery disease, carotid stenosis, hypertensive cardiopathy, lower extremity arterial disease. Outcomes. Groups were homogenous regarding gender distribution, creatinine levels and diabetes mellitus prevalence. We found no a statistically significant difference regarding comorbidities between the two groups. Lactate dehydrogenase and alkaline phosphatase had a statistically significant association with aortic arch calcification (p = 0.043, p = 0.006 respectively). Conclusions. Increased alkaline phosphatase remains an important risk factor for aortic arch calcification even in patients with less advanced CKD. Lactate dehydrogenase is yet to be validated as a marker for aortic arch calcification in CKD patient, however, our study reports a statistically significant association between lactate dehydrogenase and aortic arch calcification in patients with CKD.

Keywords

• aortic arch calcification
• chronic kidney disease
• hypertension