Vascular calcification of the aortic arch and peripheral artery in haemodialysis patients with and without diabetes mellitus.

AIM to look for differences in clinical characteristics, and differences in the role of mineral metabolism disorders and inflammation in diabetic and non diabetic patients. METHODS subjects were 127 patients on maintenance haemodialysis: 46 with DM and 81 without. Vascular calcification of the aortic arch and peripheral artery were recorded qualitatively using x-ray of the chest and lower extremities. Clinical characteristics and laboratory values were taken from the medical records. RESULTS the overall prevalence of vascular calcification was similar in our haemodialysis patients, with or without DM (26.1% vs 25.9%). The diabetic patients were in general of older age (58.5+10.3 vs 51.6+12.6 years, p<0.05), had lower diastolic BP (80+14 vs 86+14 mmHg, p<0.05), and higher prevalence of isolated peripheral artery calcification (13% vs 2.5%, p<0.05). Vascular calcification in diabetic haemodialysis patients occurred at the same rate in spite of a lower serum P, (5.7+1.5 vs 6.9+1.5 mg/dl, p<0.05), and Ca X P product (52.3+14.5 vs 60.7+14.5, p<0.05), and shorter HD vintage (1.3+0.9 vs 3.2+3.3 years, p<0.05). In a sub analysis comparing patients according to presence and location of vascular calcification, patients with vascular calcification of the peripheral artery only were mostly diabetics (75%), had lower serum Ca (8.6+0.5mg/dl), P (6.7+0.6mg/dl), Ca x P product (57.4+5.10 mg2/dl2), and higher serum CRP (1.70+1.59mg/dl). CONCLUSION diabetic patients on HD may be at higher risk for peripheral artery calcification, at lower serum Ca, P, and Ca X P product. The higher CRP may indicate a higher inflammatory status, which is probably the major risk factor for vascular calcification of the peripheral artery.