Abstract
Background and Aims
Vascular calcification has now been recognized as a major problem in dialysis patients because of its strong influence on the prognosis of this population. Several reports have shown the strong relationship between vascular calcification and clinical outcomes including cardiovascular events and arteriovenous fistula (AVF)survival.
The aim of this study is to evaluate the severity of vascular calcifications in our hemodialysis patients and to determine its impact on the AVF survival.
Method
It is a transversal descriptive and analytical study including chronic haemodialysis patients in our unit of the nephrology department.
A lateral lumbar spine radiograph was taken: the aortic arch calcification(ACC) score (VCS) was calculated according to the score validated by Kauppila and Schousboe. The overall VCS ranged from 0 to 24.
Results
Our study included 55 patients divided into 31 men and 24 women with a sex ratio of 1.29. The mean age was 49.54 ± 12.66 years. The mean duration in HD was 96.16± 73 months. 76.8% of the patients have hypertension, 26.8% are diabetic and 14.3% are smokers. AVF failure was noted in 34 patients (60.7%).
We divided our population in 3 groups: G1:23 patients with a low VCS (41.1%), G2: 15 patients with a moderate VCS (26.8%) and G3: 17 patients with a severe VCS (30.4%).
Patients in G2 and G3 were more frequently diabetics (p=0.05): over 50% of patients in G3 were diabetic and the mean duration in HD was longer: 133 months in G3, 102 months in G2 and 74 months in G1 with a significant difference p=0.03.
We noted that AVF failure was more frequent in patients in G2 and G3 (65.7%) patients) versus patients in G1 (39.13%) with a significant difference (p=0.01)
Conclusion
vascular access dysfunction is one of the leading causes of morbidity and mortality in haemodialysis patients We have demonstrated throw this study the relation between the presence of higher AAC grade and the poor survival of AVF in our patients.
So, an identification of these ACC by a simple lateral lumbar spine radiograph would allow the clinician to implement more rigorous and planned monitoring for such AVFs.
Comparison of post surgical results in medial and lateral lumbar spine herniated discs: Own case series experience