Abstract: 【Abstract】Objective To investigate the significance of artery tree images in different regions on plain X-ray films to evaluate vascular calcification in maintenance hemodialysis patients. Methods Eighty-two patients were enrolled in this cross- sectional study. Their demographic and clinical data were collected and biochemical parameters relating to vascular calcification were examined. We used plain X-ray films of postanterior chest, pelvis and hands to determine the vascular calcification of aortic arch, medial and radial arteries. We then compared these indicators in patients with various types of artery calcification and those without vascular calcification, analyzed the risk factors for various types of vascular calcification, and evaluated the significance of calcification in different arteries on vascular calcification and diagnosis of cardiovascular complications. Results The prevalence of arterial calcification was 64.6% (53/82), 48.8% (40/82) and 26.8% (22/82) in aortic arch, medial artery and radial artery, respectively. Regression analysis showed that age was the risk factor for aortic arch calcification, dialysis duration and diabetes history were the risk factors for medial and radial artery calcification, and medial and radial artery calcification were the risk factors for cardiovascular disease (OR=9.580, P=0.001 for medial artery calcification; OR=3.104, P=0.044 for radial artery calcification). The total calcification score was 4, 6 and 8 for aortic arch, medial artery and radial artery (P=0.006), respectively. The overall vascular calcification was higher in patients with radial artery calcification. ROC curve analysis found that the total calcification score for medial arteries was useful for the diagnosis of cardiovascular
complications (AUC=0.720, P=0.006). Conclusion The incidence of aortic arch calcification was the highest in various types of arterial calcification in hemodialysis patients. The overall calcification was higher in patients with radial artery calcification than in those with aortic arch or medial artery calcification.
Dialysis duration was the risk factor for medial artery calcification and radial artery calcification. The total calcification score for medial arteries was useful to predict cardiovascular complications.

Key words: Hemodialysis, plain X-ray films, Vascular calcification