Abdominal aortic calcification in patients receiving maintenance haemodialysis: prevalence and associated factors at a tertiary care centre

Abstract Background Patients with chronic kidney disease (CKD), particularly those receiving maintenance haemodialysis, are at increased risk of cardiovascular morbidity and mortality, partly due to vascular calcification. Abdominal aortic calcification (AAC) is a simple radiographic marker of vascular disease, but regional data from Pakistan remain limited. This study aimed to determine the prevalence of AAC and identify factors associated with its presence among patients receiving maintenance haemodialysis. Methods This cross sectional study included 197 adults receiving maintenance haemodialysis for more than three months at the Multan Institute of Kidney Diseases. AAC was assessed using lateral abdominal radiographs and quantified using the Kauppila scoring system. A score ≥ 1 was considered indicative of AAC. Clinical and biochemical variables were compared according to AAC status, and multivariable binary logistic regression was performed to identify factors independently associated with AAC. Results The mean age of participants was 44.89 ± 14.31 years, and 116 (58.9%) were male. AAC was present in 92 patients (46.7%). In multivariable analysis, increasing age was independently associated with AAC (adjusted OR 1.09 per year, 95% CI 1.05 to 1.13; p < 0.001). Diabetes mellitus was also independently associated with AAC (adjusted OR 5.17, 95% CI 1.30 to 20.50; p = 0.020). Hypertension, BMI, Chronic GN, smoking history, and intact PTH were not significantly associated with AAC after adjustment. Conclusions AAC was common in this maintenance haemodialysis cohort, affecting 46.7% of patients. Increasing age and diabetes mellitus were independently associated with its presence. These findings provide additional regional data on vascular calcification among patients receiving maintenance haemodialysis in Pakistan and support further evaluation in larger multicentre prospective studies.