Comparison of Coronary Artery Calcification in Peritoneal and Hemodialysis Patients

Background/Purpose: Cardiovascular disease accounts for more than 50% of deaths among patients with end-stage renal disease, and numerous factors have been proposed that may contribute to this increased risk of death. Coronary artery calcification has been recognized as one of the important risk factors for cardiovascular disease in patients undergoing dialysis. The aim of this study was to compare the coronary artery calcification score (CACS) in peritoneal dialysis (PD) and hemodialysis (HD) patients, and to assess the effect of dialysis during a 12-month period. Methods: Multidetector computed tomography was performed in 33 chronic dialysis patients (15 PD and 18 HD patients; mean age, 54 years) at Months 1, 6, and 12 during the study period. Blood samples were collected from each patient monthly to measure the serum levels of calcium and phosphorus. Results: The CACSs were significantly increased at Month 12 versus Month 1 in both PD and HD patients (p<0.05), and no significant differences were found between the two groups (p= 0.09). However, the CACS increased during the first half of the study period and then decreased significantly in the second half of the study period. Levels of serum calcium increased during the study period in both the PD and HD groups (p<0.05), but serum phosphorus levels increased only in the HD group (p<0.05). No significant relationship was found between the CACS and calcium-phosphorus product in either group. Conclusions: Our data suggest that the increase in CACS is not different between the PD and HD patients. Furthermore, the decrease in CACS between Months 7 and 12 suggests that there could be a factor other than the level of the calcium-phosphorus product that accounts for the variation in CACS in both groups.