Endocrine Abstracts

Background: Mineral and bone disorders in chronic kidney disease (CKD-MBD) is a systemic disorder of mineral metabolism due to CKD, which is manifestedby abnormalities of calcium, phosphorus, parathormone (PTH) and vitamin D; renal osteodystrophy; extraskeletal calcification. In patients with CKD, vascular calcification occurs 10–20 years earlier than in the general population, and is highly prevalent (40–92%) in the hemodialysis population. «AngioScan-01» is a professional diagnostic device for assessment of arterial function state and seems promising as a screening method for calcification detection in CKD patients.

Aim: To evaluate the diagnostic value of «AngioScan-01» device for theextraskeletal calcificationdetection in CKD patients compared totraditional noninvasiveimaging tools.

Methods: 22 patients with secondary hyperparathyroidism (SHPT) were includedin the study, and 19 of them received hemodialysis. Calcification was estimated using echocardiography, doppler sonography of peripheral arteries, plain lateral lumbar X-rays, AngioScan-01 device. Laboratory tests included serum phosphorus, calcium, albumin, PTH, triglycerides, cholesterol (total, high-density lipoprotein, and low-density lipoprotein).Data analysis was performed with the Statistica 13 package (StatSoft, USA) and SPSS (IBM, USA).Quantitative data were assessed for normal distribution using the Shapiro – Wilk’s W-test. Multiple and logistic regression were used to detect calcification predictors. A prognostically significant model was considered at P < 0.05.

Results: Calcification was found in all examined patients: calcification of arterial and mitral heart valves in 54.5% (12/22 in both cases), in total femoral artery in 45.4% (10/22), and in common carotid artery in 36.4% (8/22), the thoracic aorta in 45.4% of cases (10/22), the abdominal part in 54.5% (12/22).Calcification according to «AngioScan-01» device was detected in 68.2% (15/22). The sensitivity and specificity of «AngioScan-01»compared to echocardiography was defined as 68% and 33%, with Doppler scanning as 80% and 57%, with X-rays as 86% and 71%respectively. Thelogistic regression analysis confirmed a statistically significant relationship of calcification with serum phosphorus level and calcium-phosphorus products (P < 0.05, average for phosphorus 1.87 ± 0.49 mmol/l,for calcium-phosphorus products 4.53 ± 1.44 mmol/l), but did not indicate this for calcium, parathyroid hormone levels, the severity of anemia and dyslipidemia, which may be associated with a small number of patients.

Conclusion: The «AngioScan-01» method showed diagnostic value in the vascular calcification detection in patients with SHPTin CKD and could be introduced as a simple screening method into clinical practice.

Keywords: secondary hyperparathyroidism, chronic kidney disease, vascular calcification.