IP Journal of Urology, Nephrology and Hepatology Science

Comparison between plain x-ray abdomen and CT abdomen for detection of vascular calcification in chronic kidney disease patients

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Article Type : Original Article

Author Details: K S Sajeev Kumar,Manoj T Pillai,Mohandas M K*,Jacob George,E T Arun Thomas

Volume : 3

Issue : 2

Online ISSN : XXXX

Print ISSN : XXXX

Article First Page : 38

Article End Page : 41

Abstract

Background: Vascular calcification in chronic kidney disease patients on dialysis is associated with increased cardiovascular morbidity and mortality, increased difficulty in forming vascular anastomoses (vascular grafts or AV fistulae) and performing successful coronary artery interventions (angioplasty, stenting, and coronary artery bypass grafting).
Objectives: Primary objective was to find the sensitivity and specificity of plain X-ray abdomen lateral view for detection of vascular calcification in CKD patients on hemodialysis. Finding the association of various clinical and biochemical parameters with vascular calcification in CKD patients on hemodialysis and comparing the two year survival of patients with and without vascular calcification were the secondary objectives.
Materials and Methods: CKD patients aged between 18-80 years undergoing hemodialysis for at least three months from a tertiary care hospital of South India were selected. Patients were enrolled between March 2014 and August 2014. Clinical and biochemical parameters of these patients were recorded. Plain X-ray abdomen lateral view and non contrast CT abdomen of these patients were taken. X-ray and CT image were reported by separate radiologists blinded to each other. All the patients were followed up for 2 year.
Results: Out of the 80 patients, 62 (77.5%) were males. Mean age of the study population was 49.9 +12.2 years. Vascular calcification was present on CT in 63 patients and on X-ray in 32. Compared to CT abdomen, X-ray abdomen had a sensitivity of 47.6% and specificity of 88.2% for detecting vascular calcification. Age was found to be a significant risk for vascular calcification with odds ratio 1.213 (95% CI 1.103-1.334), P<0 P=0.468), P=0.008).>
Conclusion: Plain X-ray abdomen lateral view can be considered as the investigation of choice for routine screening as it is cheap, non invasive, have better cost benefit ratio with lesser radiation when compared to CT abdomen, high specificity, and picks up calcifications that are clinically more relevant.

Keywords: Chronic kidney disease, Vascular calcification, Dialysis, Plain X-ray.

Doi No:-10.18231