Okuno S et al. (2007) Presence of abdominal aortic calcification is significantly associated with all-cause and cardiovascular mortality in maintenance hemodialysis patients. Am J Kidney Dis 49: 417–425

Abdominal aortic calcification, which can be detected using a standard radiograph of the lateral abdomen, is a predictor of cardiovascular mortality in the general population. Researchers have investigated whether abdominal aortic calcification also predicts mortality in hemodialysis patients, who often have vascular calcification.

The study included 515 patients on maintenance hemodialysis at a hospital in Japan. All patients underwent radiography of the left abdomen at baseline.

Abdominal aortic calcification was present in 291 (56.5%) patients. During a mean ± SD follow-up period of 51 ± 17 months, 103 patients died; 81 of these were patients with abdominal aortic calcification at baseline, and 22 were patients without such calcification. More than one-third of deaths were caused by cardiovascular conditions such as ischemic heart disease and congestive heart failure. Patients with abdominal aortic calcification were significantly more likely to die from any cause (P <0.0001) or from a cardiovascular cause (P = 0.0001) than were patients without abdominal aortic calcification. The presence of abdominal aortic calcification was also found to be associated with all-cause mortality (hazard ratio 2.07) and cardiovascular mortality (hazard ratio 2.39) in multivariate analyses adjusted for factors such as age, presence of diabetes, creatinine level and C-reactive protein level.

The authors conclude that abdominal aortic calcification, which can be screened for easily during routine visits, might be a useful prognostic indicator in hemodialysis patients.