Predictors of abdominal aortic calcification progression in patients with chronic kidney disease without hemodialysis.

Abstract

BACKGROUND AND AIMS:

Abdominal aortic calcification (AAC) is an important predictor of cardiovascular mortality in patients with chronic kidney disease (CKD). However, little is known regarding AAC progression in these patients. This study aimed to identify risk factors associated with AAC progression in patients with CKD without hemodialysis.

METHODS:

We recruited 141 asymptomatic patients with CKD without hemodialysis [median estimated glomerular filtration rate (eGFR), 40.3 mL/min/1.73 m2] and evaluated the progression of the abdominal aortic calcification index (ACI) over 3 years. To identify risk factors contributing to the rate of ACI progression, the associations between baseline clinical characteristics and annual change in ACI for each CKD category were analyzed. The annual change of ACI (ΔACI/year) was calculated as follows: (second ACI - first ACI)/duration between the two evaluations.

RESULTS:

Median ΔACI/year values significantly increased in advanced CKD stages (0.73%, 0.87%, and 2.24%/year for CKD stages G1-2, G3, and G4-5, respectively; p for trend = 0.041). The only independent risk factor for AAC progression in mild to moderate CKD (G1-3, eGFR ≥ 30 mL/min/1.73 m2) was pulse pressure level (β = 0.258, p = 0.012). In contrast, parathyroid hormone (PTH) level was significantly correlated with ΔACI/year (β = 0.426, p = 0.007) among patients with advanced CKD (G4-5, eGFR < 30 mL/min/1.73 m2).

CONCLUSIONS:

This study suggests that the AAC progression rate was significantly accelerated in patients with advanced CKD. In addition, measuring PTH is useful to evaluate both bone turnover and AAC progression in patients with advanced CKD.

• Authors: Dai Yamamoto, Susumu Suzuki, Hideki Ishii, Kenshi Hirayama, Kazuhiro Harada, Toshijiro Aoki, Yohei Shibata, Yosuke Negishi, Yosuke Tatami, Takuya Sumi, Takeo Ichii, Kazuhiro Kawashima, Ayako Kunimura, Toshiki Kawamiya, Ryota Morimoto, Yoshinari Yasuda, Toyoaki Murohara
• Journal: Atherosclerosis (Atherosclerosis) Vol. 253 Pg. 15-21 (10 2016) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 27573734 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Parathyroid Hormone

Topics

• Aged
• Aorta, Abdominal (pathology)
• Aortic Diseases (complications, physiopathology)
• Blood Pressure
• Calcinosis (complications, physiopathology)
• Disease Progression
• Female
• Glomerular Filtration Rate
• Humans
• Kidney Failure, Chronic (pathology, therapy)
• Male
• Middle Aged
• Parathyroid Hormone (blood)
• Renal Dialysis (methods)
• Risk Factors
• Vascular Calcification (physiopathology)