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Relationship between aortic calcifications and DXA and Radiofrequency Echographic Multi-Spectrometry (REMS) acquisitions

Primary Author(s)

Angelo Fassio, MD, PhD

Research Fellow
University of Verona

Contributing Author(s)

SA

Stefano Andreola, MD, PhD

University of Verona
DG

Davide Gatti, MD

University of Verona
BB

Beatrice Bianco, MD

University of Verona
MG

Matteo Gatti, MD

University of Verona
GG

Giovanni Gambaro, MD, PhD

University of Verona
MR

Maurizio Rossini, MD, PhD

University of Verona
OV

Ombretta Viapiana, MD

University of Verona
GA

Giovanni Adami, MD

University of Verona

Introduction: Data on the relationship between peritoneal dialysis (PD), BMD and aortic calcifications (AOC) are lacking.

Objectives: to study the relationship between the degree of AOC and DXA and Radiofrequency Echographic Multi-Spectrometry (REMS) acquisitions.

Methods: Consecutive patients referring to the PD our clinic were enrolled. Lumbar spine (LS) and proximal femur REMS scans were performed, and LS (anteroposterior and laterolateral) and proximal femur DXA scans were performed as well. The degree of AOC was assessed through the semiquantitative score described by Kauppila et al, and applied to the laterolateral LS DXA scans. To test for correlations between different variables, we used the Pearson’s correlation for continuous variables and Spearman’s rho for discrete variables. Multiple regression analysis was performed to adjust for age and body mass index (BMI) the correlation between BMD and the CKD duration. Written informed consent was obtained from all participants (protocol 1483CESC).

Results: 41 total patients were enrolled (table 1).
We found a statistically significant positive correlation of moderate strength between the total calcification score and the difference between the DXA AP T-score and the DXA LL T-score at the LS (p < 0.01, Spearman’s rho = 0.402), figure 1.
After adjustment for confounders, we found a significant negative between the LS and femoral neck BMD measured through REMS and CKD duration (table 2). The same correlation was not significant then BMD was assessed with DXA.

Conclusions: Our study confirmed that the overestimation of DXA BMD assessed with the anteroposterior scan is indeed influenced by AOC. Furthermore, our data suggest that REMS might be an interesting tool for the investigation of bone changes in CKD.

Figure 1: scatter plot reporting the relationship between the difference between the AP and LL T-scores and the aortic calcifications score.