Soft tissue calcifications in patients on dialysis treatment

Hippokratia 2004, 8(4):188-190

D Yonova, M Georgiev, S Antonov, Z Kirijakov
Dialysis Clinic, Medical University Hospital “Alexandrovska”, Sofia, Bulgaria


Background: Patients with end stage renal failure on dialysis treatment may develop several types of soft tissue calcification, including visceral, periarticular and vascular calcifications due to a number of known and unknown factors. The aim of the study was to evaluate the dispersion of vascular and periarticular soft tissue calcifications of a random group of haemodialysis (HDT) patients and their relation to parathyroid hormone (PTH) and some other biochemical markers.
Material and methods: Four middle-range arteries a.a. carotis communis sinistra et dextra and a.a. femoralis sinistra et dextra were investigated by B-mode echography; 4 typical for calcium deposits periarticular regions of the body were checked by x-ray and visible skin calcifications were registered in 40 patients (on HDT more than 3 months) for evaluation of calcification rate, comparing them with some biochemical parameters: PTH, alcaline phosphatase (AP), Ca, Ca++, P and C-reactive protein (CRP).
Results: The study revealed a high percentage (95 %) of vascular calcifications (VC), and a low percentage of periarticular and skin calcifications (3.3 %). A significant correlation was found between PTH / AP (r: 0.7, p < 0.001), PTH / VC (r: 0.51, p < 0.001), PTH / Ca++ (r: 0.40, p < 0.01) and PTH / CRP (r: 0.39, p < 0.01) as well as between CRP / VC (r: 0.38, p < 0.01).
Conclusion: The study suggests an influence of secondary hyperparathyroidism and existing inflammatory status on vascular calcifications in dialysis patients but no relation of both factors to periarticular and skin calcium deposits, which would require a different way of therapy.