Prognostic Value of Vascular Calcification in Long-Term Outcomes in Obese and Non-Obese Patients with Chronic Kidney Disease

The possible protective effect of obesity in the outcomes of chronic kidney disease (CKD) patients is an understudied field. We aimed to evaluate the prognostic value of vascular calcification (VC) on long-term outcomes in obese and non-obese CKD patients. We conducted a single-centre, prospective observational study of 150 CKD patients. Patients were divided into two groups using body mass index (BMI) scores (BMI ≥ 30 kg/m² and BMI < 30 kg/m²). Lateral lumbar X-rays (Kauppila score), the ankle-brachial index (ABI), and echocardiography were used for assessing VC. By the 11.2-year follow-up, 70 patients had died (47%). Twenty-four patients had had CV complications: stroke, myocardial infarction, decompensated heart failure, amputation caused by atherosclerosis, and aortic rupture. Among obese patients (BMI ≥ 30 kg/m²), only LVH was a significant predictor of CV complications (<i>p</i> = 0.01) and mortality (<i>p</i> = 0.004). In patients with BMI < 30 kg/m², predictors of CV complications and mortality were ABI (<i>p</i> = 0.03; <i>p</i> = 0.009), LVH (<i>p</i> = 0.02 for CV complications) and heart valve lesions (<i>p</i> = 0.009; <i>p</i> = 0.004). There were no differences in the measured parameters of VC between the obese and non-obese groups. Moreover, no significant differences were found comparing patients with and without obesity according to the studied parameters; we found no significant differences in complications and mortality. VC in patients with CKD is a significant complication that negatively impacts outcomes. Obesity does not have a protective effect in long-term outcomes in CKD patients.