Abstract: Objective To investigate the progression of abdominal aortic calcification (AAC) and its risk factors in maintenance hemodialysis (MHD) patients.  Methods  Forty-seven MHD patients treated in Beijing Jishuitan Hospital from December 2019 to April 2022 were enrolled in this study. Two lumbar quantitative CT images performed during the follow-up period were retrospectively reviewed; 8 slices were sequentially extracted, and AAC score was obtained by the Image J software. According to the average annual AAC-growth, the patients were divided into slow progression group (n=23) and rapid progression group (n=24), and then analyzed using univariate and multivariate regression methods.  Results  The median follow-up time was 2.15(2.14, 2.20) years, and 95.74% of the patients had the progression of AAC. The median baseline AAC score was 59.55 (20.03, 122.46), and the median follow- up AAC score was 78.25(31.93,141.92). Compared with the slow progression group, the rate of smoking (χ2=6.715, P=0.010), baseline AAC score (Z=-3.629, P＜0.001), time averaged serum phosphorus (t=-3.538, P=0.001), time averaged calcium and phosphorus product (t=-3.173, P=0.003), and time averaged intact parathyroid hormone (t=-3.060, P=0.004) were significantly higher, and the durations of oral sevelamer carbonate (Z=-2.122, P=0.034) and cinacalcet hydrochloride (Z=    -2.880, P=0.004) were significantly longer in the rapid progression group. Multivariate logistic regression showed that baseline AAC score (OR=1.020, 95% CI: 1.006～1.035, P=0.005) and time averaged serum phosphorus (OR=115.585, 95% CI: 3.412～3915.747, P=0.008) were the risk factors for rapid progression of AAC in MHD patients.  Conclusion  AAC progresses rapidly in MHD patients. Higher baseline AAC score and hyperphosphatemia were the risk factors for rapid AAC progression in MHD patients.

Key words: Maintenance hemodialysis, Abdominal aortic calcification, Progression, Risk factor