ARTERIAL CALCIFICATION AND PATHOLOGY IN UREMIC PATIENTS UNDERGOING DIALYSIS

Arterial samples obtained from uremic patients were compared with those obtained from nonuremic control subjects. Arteries from the uremic patients showed fibrous or fibroelastic intimai thickening, calcification of the internal elastic lamella, medial ground substance and medial elastic fibers, and disruption and reduplication of the internal elastic lamella. Lipid deposition was seen infrequently. The calcium concentrations of the arteries of the patients were greater than those of the control subjects. Correlations were found between the degree of intimai thickening and the duration of renal disease, and between arterial calcification and both the duration of hypertension and the duration of renal disease. In the control subjects, positive exponential correlations were found between age and arterial calcium concentrations, but at any age the calcium concentration was greater in the aorta than in the other arteries. This study has demonstrated that pathologic changes are extremely common in the arteries of uremic patients, that calcification is an integral part of this disease process and that, despite hyperlipidemia, lipid deposition is not an initiating factor. The changes seen probably represent an acceleration of the normal arterial aging process. This study has also shown that the disease seen may be, in part, related to the duration of uremia and to the duration of hypertension. It is likely that the arterial disease seen in uremia is a result of a summation of the many atherogenic risk factors present in these patients. © 1979.