Doctoral defence: Jana Uhlinova “Vascular calcification and its associations with obesity and bone mineral density in chronic kidney disease”

On 20 February 2026 Jana Uhlinova will defend her thesis “Vascular calcification and its associations with obesity and bone mineral density in chronic kidney disease”.

Supervisors:
Professor of nephrology Mai Rosenberg, University of Tartu
Professor of propaedeutics of internal medicine Margus Lember, University of Tartu

Opponent:
Associate professor Kaj Peter Metsärinne, Turu University Hospital (Finland).

Summary:
Chronic kidney disease (CKD) is the progressive disease and the major cause of mortality in CKD patients are cardiovascular (CV) complications. Obesity is one of the traditional risk factors for atherosclerosis and subsequent CV events in the general population, and in CKD patients. However, an “obesity paradox” has been observed in dialysis patients, whereby overweight is associated with improved outcome.

One of the alterations in body composition in CKD is kidney disease-mineral and bone disorder (CKD-MBD), a systemic disorder of mineral metabolism due to the kidneys’ failure. CKD-MBD is associated with loss of bone tissue mass, increased risk of fractures, increased vascular calcification (VC), vascular stiffening and vascular senescence. Besides that, associations between obesity and formation of extraosseous calcification in CKD were previously described only by few authors and results were controversial.

The general aim of this study was to clarify the associations between body composition and VC in CKD patients. The main cohort consisted of 168 consecutive patients with CKD of different stages.

The study compared VK in obese and non-obese CKD patients, investigated the relationship between VK and bone mineral density (BMD), evaluated the prognostic role of aortic calcification and peripheral arterial disease on mortality and CV events, and assessed the prognostic value of VK in obese and non-obese CKD patients. Lumbar lateral radiographs, ankle-brachial index (ABI), and echocardiography were used to assess extraskeletal calcification. DEXA scan was used to examine bone density.

VC is most pronounced in obese patients with reduced kidney function. Obesity has no protective effect in CKD patients. The results of this study didn`t support “obesity paradox” nor in whole group of patients neither in subgroups with different stages of CKD. There is an inverse relationship between VC and BMD. Pronounced abdominal aortic calcification is a strong predictor of all-cause mortality and CV events in CKD patients. Obesity has no protective effect on long-term outcomes in CKD patients.

You can also watch the defense via Teams.