Journal Article

Are peritoneal calcifications in long-term peritoneal dialysis related to aortic calcifications and disturbances in mineral metabolism?

Anniek Vlijm, Saffire S.K.S. Phoa, Marlies Noordzij, Anje M. Spijkerboer, Joost van Schuppen, Jaap Stoker, Dirk G. Struijk and Raymond T. Krediet

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 1, pages 304-308
Published in print January 2011 | ISSN: 0931-0509
Published online June 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq374
Are peritoneal calcifications in long-term peritoneal dialysis related to aortic calcifications and disturbances in mineral metabolism?

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Background. Peritoneal calcifications are associated with long-term peritoneal dialysis (PD). Case reports have suggested a relation with disturbances in mineral metabolism such as the presence of severe hyperparathyroidism. Our aim was to investigate whether relationships are present between peritoneal calcifications and aortic calcifications or disturbances in mineral metabolism in long-term PD patients.

Methods. We included all long-term PD patients (PD ≥4 years) in our centre from 1996 to 2008 who had undergone an abdominal computed tomographic (CT) scan. The scans were reviewed by two experienced radiologists in consensus. The presence or absence of peritoneal calcifications was scored, and a severity scoring system for abdominal aortic calcifications was used: 1 = none, 2 = mild, 3 = moderate, 4 = severe and 5 = very severe. For each patient, laboratory data on plasma calcium corrected for albumin, phosphorus and parathyroid hormone (PTH) levels were retrieved every 6 months up to 5 years prior to the CT scan. Individual mean values over 5 years were calculated.

Results. We included 31 patients: 12 patients with peritoneal calcifications and 19 patients without. No difference was found in aortic calcification scores (median scores: 3 versus 3). Also, median (range) calcium, 10.7 (9.6–11.5) versus 10.3 (9.4–11.3) mg/dL; phosphorus, 5.2 (3.4–7.0) versus 4.9 (2.9–6.5) mg/dL; and PTH levels, 271 (101–910) versus 263 (40–1197) pg/mL were not different between patients with and without peritoneal calcifications.

Conclusions. The presence of peritoneal calcifications in long-term PD patients could not be related to the presence of aortic calcifications or disturbances in mineral metabolism. Perhaps, local peritoneal factors play a role in the formation of peritoneal calcifications.

Keywords: aortic calcifications; computed tomography; long-term PD; mineral metabolism; peritoneal calcifications

Journal Article.  3162 words.  Illustrated.

Subjects: Nephrology

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