Classification of chronic kidney disease biomarkers to predict coronary artery calcium.

Abstract

BACKGROUND/AIMS:

The link between CKD and CAC has been mostly established by studies of patients who have abnormally high phosphorus levels and advanced CKD or end-stage renal disease. The aim of this study was to examine if there are distinct trajectory classes of serum phosphorus (controlling for eGFR) that are associated CAC in a relatively healthy, community sample.

METHODS:

Phosphorus and eGFR were classified as a combined biomarker variable with 4 trajectory classes by growth mixture modeling. This classification variable was subsequently used to predict CAC as both a binary (i.e., onset) and continuous (i.e., accumulation) outcome using a two-part growth model.

RESULTS:

Membership in one class of phosphorus trajectory versus the next lowest level was associated with a 97.9 Agatston unit increase in CAC (p <.001). The magnitude of this finding is similar in size as some primary risk factors for cardiovascular disease, including a 55.3 Agatston unit (p <.001) increase associated with age, and a--75.1 Agatston unit (p <.001) decrease associated with female gender.

CONCLUSIONS:

Classification of phosphorus trajectories provides further definition for prediction of CAC within the conventional 'normal' range. Classifying trajectories may help determine clinically-relevant thresholds for interventions aimed at phosphorus reduction.

• Authors: Sterling McPherson, Celestina Barbosa-Leiker, Robert Short, Katherine R Tuttle
• Journal: Kidney & blood pressure research (Kidney Blood Press Res) Vol. 36 Issue 1 Pg. 26-35 ( 2012) ISSN: 1423-0143 [Electronic] Switzerland
• PMID: 22777315 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 S. Karger AG, Basel.

Chemical References

• Biomarkers
• Phosphorus
• Calcium

Topics

• Adult
• Age Factors
• Biomarkers (blood)
• Calcium (metabolism)
• Cohort Studies
• Coronary Artery Disease (epidemiology)
• Coronary Vessels (metabolism)
• Female
• Glomerular Filtration Rate (physiology)
• Humans
• Linear Models
• Longitudinal Studies
• Male
• Middle Aged
• Models, Statistical
• Phosphorus (blood, classification)
• Predictive Value of Tests
• Renal Insufficiency, Chronic (epidemiology)
• Risk Factors
• Sex Factors
• Tomography, X-Ray Computed