【Abstract】 Objective To explore the risk factors of coronary calcification in elderly patients with maintenance hemodialysis (MHD). MethodsThe clinic data of 100 elderly patients who underwent MHD therapy from April 2019 to April 2021 in the First Affiliated Hospital of Chengdu Medical College were analyzed. The patients were divided into 2 groups according to coronary artery calcification score (CACS)：Non-coronary artery calcification group (CACS≤100，n=36），coronary artery calcification group (CACS＞100，n=64）. ResultsSignificant differences were detected in age，dialysis age，diabetes，creatinine and magnesium between the two groups(P<0.05). Spearman′s correlation analysis revealed that magnesium (r=-0.394，P<0.01) and creatinine (r=-0.232，P=0.020) were negatively related with coronary calcification while age (r=0.343，P<0.01 )，dialysis age (r=0.203，P=0.043) and diabetes (r=0.230，P=0.022) were positively related with coronary calcification. Binary logistic regression analysis showed that age，dialysis age and diabetes were independent risk factors whereas magnesium was a protective factor of coronary calcification (P<0.05). The area under the ROC curve of the age，dialysis age，diabetes and magnesium in diagnosing coronary calcification were 0.706，0.622，0.617，0.737，respectively. The area under the ROC curve of the above four in Joint diagnosis of coronary calcification was 0.850. ConclusionOn the basis of good calcium and phosphorus management，the age，dialysis age and diabetes are independent risk factors，while the serum magnesium is a protective factor of coronary calcification in elderly MHD patients，and they have a good joint diagnostic value for coronary calcification in elderly MHD patients.