Journal
ATHEROSCLEROSIS
Volume 271, Issue -, Pages 53-60Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2018.02.009
Keywords
Coronary artery disease; Chronic kidney disease; Risk factors; Epidemiology
Funding
- National Institute of Diabetes and Digestive and Kidney Diseases [U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, U01DK060902]
- Perelman School of Medicine at the University of Pennsylvania Clinical and Translational Science Award NIH/NCATS [UL1TR000003]
- Johns Hopkins Institute for Clinical and Translational Research (ICTR) [UL1 TR-000424]
- University of Maryland GCRC [M01 RR-16500]
- Clinical and Translational Science Collaborative of Cleveland [UL1TR000439]
- Michigan Institute for Clinical and Health Research [UL1TR000433]
- University of Illinois at Chicago [CTSA UL1RR029879]
- Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases [P20 GM109036]
- Kaiser Permanente NIH/NCRR UCSF-CTSI [UL1 RR-024131]
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR000424, UL1TR000003, UL1TR002003] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR029879, UL1RR024131] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [K23DK094829, U01DK060980, U01DK060990, U01DK061022, U01DK061021, U24DK060990, R01DK072231, U01DK060984, U01DK060902, U01DK061028, U01DK060963] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [P20GM109036] Funding Source: NIH RePORTER
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Background and aims: Coronary artery calcification (CAC) is common among patients with chronic kidney disease (CKD) and predicts the risk for cardiovascular disease (CVD). We examined the associations of novel risk factors with CAC progression among patients with CKD. Methods: Among 1123 CKD patients in the Chronic Renal Insufficiency Cohort (CRIC) Study, CAC was measured in Agatston units at baseline and a follow-up visit using electron beam computed tomography or multidetector computed tomography. Results: Over an average 3.3-year follow-up, 109 (25.1%) participants without CAC at baseline had incident CAC and 124 (18.0%) participants with CAC at baseline had CAC progression, defined as an annual increase of >= 100 Agatston units. After adjustment for established atherosclerotic risk factors, several novel risk factors were associated with changes in CAC over follow-up. Changes in square root transformed CAC score associated with 1 SD greater level of risk factors were -0.20 (95% confidence interval, -0.31 to -0.10; p < 0.001) for estimated glomerular filtration rate, 0.14 (0.02-0.25; p = 0.02) for 24-h urine albumin, 0.25 (0.15-0.34; p < 0.001) for cystatin C, -0.17 (-0.27 to -0.07; p < 0.001) for serum calcium, 0.14 (0.03-0.24; p = 0.009) for serum phosphate, 0.24 (0.14-0.33; p < 0.001) for fibroblast growth factor-23, 0.13 (0.04-0.23; p = 0.007) for total parathyroid hormone, 0.17 (0.07-0.27; p < 0.001) for interleukin-6, and 0.12 (0.02-0.22; p = 0.02) for tumor necrosis factor-alpha. Conclusions: Reduced kidney function, calcium and phosphate metabolism disorders, and inflammation, independent of established CVD risk factors, may progress CAC among CKD patients. (C) 2018 Elsevier B.V. All rights reserved.
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