摘要Objective Cardiovascular disease(CVD)is the leading cause of mortality in patients with end-stage renal disease(ESRD)undergoing maintenance dialysis.To further clarify this critical relationship,we conducted a prospective study to evaluate the prognostic significance of calcification in different segments of the thoracic aorta for all-cause mortality in this patient population.Methods This prospective study enrolled stable adult patients who were undergoing maintenance hemodialysis(MHD)at our center between July 2019 and December 2020 and who had available chest X-rays or computed tomography(CT)scans.Thoracic aortic calcification(TAC)was assessed via chest CT or X-ray imaging.Cox proportional hazards models and Kaplan-Meier curves were used to describe the risk factors for mortality.Results At a mean follow-up of 3.95 years,18 of 62 patients had died.Cox proportional hazards regression models dem-onstrated that elevated systolic blood pressure(HR 1.029),aortic arch calcification(AAC)(HR 1.104),and descending thoracic aortic calcification(DTAC)(HR 1.066)were independent risk factors for all-cause mortality in patients with MHD(all P＜0.05).Additionally,the presence of severe DTAC or severe AAC emerged as an independent risk factor for death in this patient population(log-rank test,P＜0.05).Conclusion AAC and DTAC are important predictors of all-cause mortality among patients undergoing maintenance hemodialysis.