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Comparison of Vascular Calcification Scores on Plain Radiographs to Predict Coronary Artery Disease According to Dialysis Modality

대한신장학회지
2011년 30권 3호 p.292 ~ p.301
김준모 ( Kim Joon-Mo ) - 동아대학교 의과대학 내과학교실

김정민 ( Kim Jung-Min ) - 동아대학교 의과대학 내과학교실
이수미 ( Lee Su-Mi ) - 동아대학교 의과대학 내과학교실
유승희 ( Ryu Seung-Hee ) - 동아대학교 의과대학 내과학교실
김기현 ( Kim Ki-Hyun ) - 동아대학교 의과대학 내과학교실
김성은 ( Kim Seong-Eun ) - 동아대학교 의과대학 내과학교실
손영기 ( Son Young-Ki ) - 동아대학교 의과대학 내과학교실
한진영 ( Ham Jin-Yeong ) - 동아대학교 의학연구소
하동호 ( Ha Dong-Ho ) - 동아대학교 의과대학 영상의학과
안원석 ( An Won-Suk ) - 동아대학교 의과대학 내과학교실

Abstract

Purpose:Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) in hemodialysis (HD) patients. However, there is no report comparing VC scores on plain radiographic films according to dialysis modality. We hypothesized that there are some differences of VC scores on plain radiographs for the assessment of CAD according to dialysis modality.

Methods:We recruited 78 peritoneal dialysis (PD) patients and compared to 61 HD patients. We defined significant VC as any one finding among the abdominal aortic calcification (AAC) score ≥5, VC score of the hands and pelvis ≥3, or medial artery calcification of the feet on plain radiographs.

Results:The prevalence of CAD and significant VC were not different according to dialysis modality.
Every VC score on the plain radiographs was highly correlated with each other, but VC evaluation on plain radiographs by single method overlooked nearly 30% of other significant VC sites in PD and HD patients. AAC score was most useful method for the prediction of CAD as a single VC scoring method.
There was no association between VC of the feet and CAD in PD patients. Lower high density lipoprotein cholesterol was associated with significant VC on plain radiograph in PD patients.

Conclusion:Significant VC formation on plain radiographs was not different according to dialysis modality. It is helpful to check several plain radiographs for the decision of CAD evaluation and not overlooking significant VC in both HD and PD patients.

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학술진흥재단(KCI) KoreaMed 대한의학회 회원 
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