COMBINATION OF THORACIC AORTIC CALCIFICATION INDEX AND C-REACTIVE PROTEIN TO PREDICT ALL-CAUSE MORTALITY IN MAINTENANCE HEMODIALYSIS PATIENTS

Yan Shen^{1, 2, #}, Zhenguo Qiao^{3, #}, Lianglan Shen², Jiashan Huang⁴, Dongmei Chen², Jiajia Chen², Hongli Yang², Yan Xie^{1, *}

¹Department of Geriatrics, The First Affiliated Hospital of Soochow University, Suzhou 215006, China - ²Department of Nephrology, The Second Affiliated Hospital of Nantong University, Nantong 226006, China - ³Department of Gastroenterology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou 215200, China - ⁴Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong 226006, China 

Objective: The risk factors of all-cause mortality in maintenance hemodialysis (MHD) patients were investigated alongside the value of thoracic aortic calcification index (TACI) combined with C-reactive protein (CRP) levels to predict all-cause mortality in MHD patients. 

Methods: A total of 312 MHD patients were followed up either until death or 30th November 2020.TACI were calculated semi-quantitatively using a blinded method, and demographic, clinical, and laboratory parameters including mineral metabolism markers were collected for each patient. 

Results: TACI and CRP in the death group were both significantly higher than those in the survival group. Age, dialysis age, hemoglobin, corrected calcium, CRP, and TACI were independent risk factors for all-cause death in MHD patients. Kaplan-Meier survival analysis demonstrated that the 1-, 3-, and 5-year overall survival rates of patients in the TACI≥1.67% group were significantly lower than those with a TACI<1.67% (P<0.001). The decision tree (DT) model determined that a of TACI≥1.67% combined with a CRP>20.61mg/L were important determinant variables for predicting high all-cause mortality in MHD patients.

Conclusion: TACI combined with CRP can therefore aid prediction of all-cause mortality in MHD patients. TACI and CRP are therefore promising interventional targets for reducing all-cause mortality in MHD patients.