Evaluation of the relation between vascular and cardiac calcification and osteoporosis, and detection of risk factors in patients undergoing hemodialysis

We aimed to evaluate the presence of mitral and aortic valve calcification and aortic stiffness in hemodialysis patients and their risk factors and to find out relationship between bone mineral density and vascular calciffication. The study population consisted of 16 female and 36 male; a total of 52 hemodialysis patients (mean dialysis period was 91.90±77.18 months and 13 had DM). Mitral and aortic valve calcification and aortic stiffness were evaluated by echocardiography on the non-dialysis days. Systolic and diastolic blood pressures were recorded. Bone mineral density was measured by dual energy x-ray absorbiometry (DEXA) using lumbar and femoral regions as well as the radial region of the arm without AV fistula. BMD values were classified as T and Z scores according to WHO criteria. Blood urea nitrogen (BUN), creatinine, calcium (Ca), phosphorus (P), calcium-phosphorus product, alkalene phosphotase (ALP), albumin, hemoglobin(Hb), C reactive protein(CRP), ferritin, low density lipoprotein (LDL), cholesterol, triglyceride, high density lipoprotein (HDL), bicarbonate(HCO3), parathormone(PTH) values were recorded. Body mass indeces (BMI) were calculated. Twenty-two patients (42.3%) had mitral and 25 (48.1%) had aortic valve calcification. Aortic valve calcification and aortic stiffness were found to be significantly related to age. Aortic valve calcification was correlated with PTH levels. Aortic and mitral valve calcification and aortic stiffness were similar in diabetics and nondiabetics. Aortic stiffness was related with calcium-phosphorus product. Mitral and aortic valve calcification and aortic stiffness were not found to be related to BMD measurement of femoral, lumbar and radial regions. Radial Z scores were significantly related to aortic stiffness. Radial T scores revealed osteoporosis in both males and females and were correlated with dialysis period. As a conclusion, age was related to aortic valve calcification as well as aortic stiffness. Aortic and mitral valve calcification and aortic stiffness were not correlated with BMD measurements of femoral, radial and lumbar regions. Radial BMD values significantly decreased as dialysis period increased. Radial DEXA scores are more useful in evaluation of BMD in hemodialysis patients.