Aortic arch calcification and risk of cardiovascular or all-cause and mortality in dialysis patients: A meta-analysis

Studies on aortic arch calcification (AAC) and mortality risk in maintenance dialysis patients have yielded conflicting findings. We conducted this meta-analysis to investigate the association between the presence of AAC and cardiovascular or all-cause and mortality risk in maintenance dialysis patients. Observational studies evaluating baseline AAC and cardiovascular or all-cause mortality risk in maintenance dialysis patients were searched through the PubMed and Embase, CNKI, VIP and Wanfang databases until January 2016. A total of 8 studies with 3,256 dialysis patients were identified. Compared with patients without AAC, the presence of AAC was associated with greater risk of cardiovascular mortality (hazard risk [HR] 2.30; 95% confidence intervals [CI] 1.78-2.97) and all-cause mortality (HR 1.44; 95% CI 1.19-1.75). Subgroup analyses indicated that the pooled HR for cardiovascular and all-cause mortality was 2.31 (95% CI 1.57-3.40) and 1.45 (95% CI 1.08-1.96) for the grade 2/3 AAC. Peritoneal dialysis patients with AAC had greater cardiovascular (HR 3.93 vs. HR 2.10) and all-cause mortality (HR 2.36 vs. HR 1.33) than hemodialysis patients. The AAC appears to be independently associated with excessive cardiovascular and all-cause mortality in maintenance dialysis patients. Regular follow-up AAC might be helpful to stratify mortality risk in dialysis patients.