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Patients with end-stage renal disease on hemodialysis (HD have increased risk of death due to high prevalence of cardiovascular disease (CVD). The presence of vascular calcification (VC) is predictive of CVD and mortality. We conducted a study to evaluate prevalence and risk factors for VC in dialysis patients in Qatar.
This is a retrospective nationwide study was conducted in all chronic ambulatory dialysis patients in Qatar from 2020 to 2022. We used our national electronic medical record to track demographics, clinical characteristics, comorbidities, laboratory values, and diagnostic data for each patient. Vascular calcification was assessed by echocardiography (routinely done for all our dialysis population per national protocol), computed tomography, X-ray, and ultrasound.
842 HD patients were included in this study. Vascular calcifications was prevalent in 52.6% of patients. The main sites of VC were mitral valve calcifications in 55.5% of patients. Patients with VC were significantly older age and more diabetics (p=0.001 and p= 0.006 respectively). There was no statistically significant difference among patients with VC and patients without VC regarding serum calcium, phosphorus and PTH levels (P 0.946, p 0.446 and p 0.609 respectively). In multivariate analysis, diabetes mellitus was the most significant risk factor for VC (HR 1.768 95%CI 1.033-1.065, p< 0.0001). Additional risk factors were also identified, including age, higher vitamin D levels, and a greater dose of intravenous alfacalcidol. These factors exhibited significant associations with VC, with hazard ratios of 1.049 (95% CI 1.128-2.272, p < 0.0001), 1.017 (95% CI 1.005-1.030, p = 0.007), and 1.178 (95% CI 1.092-1.270, p < 0.0001), respectively.
Our study in Qatar identified a high prevalence of vascular calcification among our dialysis population. The implementation of echocardiography in dialysis patients proved to be extremely helpful for detecting vascular calcification. Diabetes mellitus nearly doubles the risk of vascular calcification in these patients. These findings are valuable for identifying risk factors, aiding in cardiovascular disease risk stratification, and optimizing preventive efforts.