Association between Vascular Calcification and Residual Renal Function

Introduction: In chronic kidney disease patients, the leading cause of mortality is cardiovascular disease. In most cases, it is related to vascular calcification. Among multiple risk factors for vascular calcification, decline of residual renal function is an important one. So far, there is scarce information about the influence of residual renal function on vascular calcification in haemodialysis patients.

Objective: To determine the association between vascular calcification and left ventricular hypertrophy in haemodialysis patients with low residual renal function.

Methods: An observational study was performed on 60 chronic kidney disease patients on maintenance haemodialysis with low renal residual function attending in dialysis units of Chittagong Medical College Hospital in Bangladesh during the period from April 2018 to March 2019. Blood samples for biochemical analysis were collected in fasting condition. At the same day, lateral lumbar radiography and M mode echocardiography was done for vascular calcification score and left ventricular hypertrophy respectively.

Results: The prevalence of vascular calcification was present in 88.3% cases in patients with low residual renal function. Patients without vascular calcification had normal left ventricular mass index in 100% cases and those with vascular calcification had increased left ventricular mass index in 75% cases, which was very highly significant. The duration of dialysis, age, gender and smoking were not statistically significant for vascular calcification. There was positive correlation of vascular calcification with fasting blood sugar, C-reactive protein, intact Parathormone, Cholesterol, body mass index, serum calcium, serum phosphate, calcium phosphate product and systolic blood pressure but it was negative for serum albumin, diastolic blood pressure and 24 hours urinary total volume.

Conclusion: Vascular calcification is very common in patients with end stage renal disease on maintenance haemodialysis. Loss of residual renal function is an important risk factor for vascular calcification. Patients with vascular calcification had significantly raised left ventricular mass index.