ASSOCIATION OF CALCIUM METABOLISM AND PULSE WAVE VELOCITY IN PATIENTS ON CHRONIC MAINTENANCE HEMODIALYSIS IN END-STAGE RENAL DISEASE

Abstract

Objective: Pulse wave velocity(PWV) is the main parameter for arterial stiffness. In patients with end-stage renal disease(ESRD), PWV is known to be associated with higher mortality. But factors related to the increased PWV in ESRD patients are not well defined. The aim of this study is to investigate the clinical factors associated with increased PWV in ESRD patients. Design and Methods : BaPWV(brachial-ankle PWV) were examined for 65 ESRD patients on hemodialysis during the period of February 7th to11th in 2005 using VP-1000(Colin, Japan). And the clinical factors including age, sex, smoking history, diabetes, blood pressure, body mass index, dry weight, body weight changes before and after hemodialysis, duration of dialysis, lipid profile, uric acid, calcium, phosphate, i-PTH, CRP, and hemoglobin were analyzed regarding the association with PWV. Results: Age was 53.8±12.0 and male/female was 31/34. BaPWV was 1892.2±523.3cm/sec and there was no difference between gender(1801.2±435 vs 1975.3±586.4, p = NS). In mutiple regression model, alkaline phosphatase level(β=0.229), calcium(β=0.639), phosphate(β=3.041), HDL(β=0.248), calcium-phosphate product(β=-3.012) were independent variables as well as age(β=0.287) and systolic blood pressure(β=0.336)(Rsq=0.451, p =0.009). Conclusions: In end-stage renal disease, parameters of calcium metabolism and HDL are closely related to PWV in addition to well-known factors such as age and systolic blood pressure.