SP549
ASSOCIATION BETWEEN TRACE ELEMENTS AND CORONARY ARTERY CALCIFICATION IN CHRONIC HEMODIALYSIS PATIENTS

INTRODUCTION AND AIMS: Cardiovascular disease (CVD) carries a major risk of mortality in hemodialysis patients. Hemodialysis patients are at risk for deficiency of essential elements and excess of toxic heavy metals. We conducted a study to measure the levels of trace elements of chronic hemodialysis patients, compare them with healthy controls and assess the influence of trace elements on calcification of coronary arteries.

METHODS: Thirty-nine hemodialysis patients dialyzed three times a week more than six months and 35 age- and sex-matched healthy individuals were included in the study. Exclusion criteria were; having active infection, active inflammatory disease, serum albumin <3,5 g/dl, coronary stent and/or by-pass operation, atrial fibrillation, cancer. None of the subjects received antibiotics, corticosteroids, anti-inflammatory drugs, cytotoxic drugs, medications including trace elements during the study period. Demographic (age, gender), clinical (height, weight, last mean 3-month pre-dialysis systolic and diastolic blood pressures) data were collected from patient files. Also last 3-month laboratory data (calcium, phosphorus, parathormon, LDL cholesterol ) collected from patient files calculated mean values. Blood samples for trace elements were collected into tubes with EDTA and stored at −20°C until assay and quantified by inductively coupled plasma mass-spectrometry (ICP-MS). Coronary artery calcification (CAC) was assessed by multi-detector computed tomography and evaluated by the same person from radiology department.

RESULTS: The serum levels of selenium and uranium were significantly lower and levels of lithium, magnesium, aluminum, nickel, strontium, cadmium, tin, platinum, lead ve thallium were significantly higher in hemodialysis patients compared to controls. The mean value of CAC score was 347,67 ± 822,35 (range 0-4224, median: 29,6). The level of cadmium was found statistically higher in the patients with high CAC scores (> median value) compared to the patients with low CAC scores (< median value). However we did not find any significance in correlations between CAC scores and trace element levels (for selenium r=-0,303, P=0,061).

CONCLUSIONS: The levels of trace elements are altered by chronic hemodialysis. Especially cadmium was found higher in patients with high CAC scores. We believe that studies with more subjects will give information to us about this association.