Renal Function Is Related to Severity of Coronary Artery Calcification in Elderly Persons: The Rotterdam Study

Abstract Background and Aims Coronary artery calcium score (CACS) allows to improve significantly predictive value of traditional tools for cardiovascular risk estimation. Reduced renal function is associated with increase of rates of cardiovascular events. Dyslipidemia is an important factor of cardiovascular system injury in chronic kidney disease. The Aim. To investigate association between glomerular filtration rate (GFR), total cholesterol and CACS. Method We performed the study on 170 patients (77 males and 93 females, aged 56 [52;63] years) who underwent CACS at Dnipropetrovsk Mechnikov Regional Hospital, Dnipro, Ukraine, from December 2017 till March 2019. Patients in the study were free of known cardiovascular disease and required reclassification of cardiovascular risk. Patients were subdivided by total cholesterol (TC) level (<5.2 mmol/l, n=83; ≥5.2 mmol/l, n=87) and by GFR (≥90 ml/min, n=64; 60-89 ml/min, n=90; 30-59 ml/min, n=16). CACS was presented in Agatston units (AU). Results Median age in groups by TC was comparable (56 [53;63] vs 56 [51;64] years, p=0.51) and elevated significantly with decline of GFR (54 [49;59], 57 [53;65] and 70 [59;77] years for patients with GFR≥90, 60-89 and 30-59 ml/min respectively, p for trend <0.001). We didn’t observe any statistically significant differences of CACS after patients subdivision, though it was higher in TC≥5.2 mmol/l group. Conclusion We didn’t find convincing data supporting significant impact of TC excess on coronary artery calcification.

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Bone health and coronary artery calcification: The Rotterdam Study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2015.02.013 ◽

2015 ◽

Vol 241 (1) ◽

pp. 278-283 ◽

Cited By ~ 21

Author(s):

Natalia Campos-Obando ◽

Maryam Kavousi ◽

Jeanine E. Roeters van Lennep ◽

Fernando Rivadeneira ◽

Albert Hofman ◽

...

Keyword(s):

Coronary Artery ◽

Bone Health ◽

Coronary Artery Calcification ◽

Rotterdam Study

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Impaired Renal Function Further Increases Odds of 6-Year Coronary Artery Calcification Progression in Adults With Type 1 Diabetes

Diabetes Care ◽

10.2337/dc12-2538 ◽

2013 ◽

Vol 36 (9) ◽

pp. 2607-2614 ◽

Cited By ~ 32

Author(s):

David M. Maahs ◽

Diana Jalal ◽

Michel Chonchol ◽

Richard J. Johnson ◽

Marian Rewers ◽

...

Keyword(s):

Type 1 Diabetes ◽

Renal Function ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Impaired Renal Function

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The role of mineral and bone metabolism disorders in the development and progression of cardiac and renal pathology in the patients presenting with long-lasting type 1 diabetes mellitus

Problems of Endocrinology ◽

10.14341/probl201359516-24 ◽

2013 ◽

Vol 59 (5) ◽

pp. 16-24

Author(s):

M S Biragova ◽

S A Gracheva ◽

A M Glazunova ◽

T I Dubrovskaia ◽

S A Martynov ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Renal Function ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Calcium Metabolism ◽

Agatston Score ◽

Cardiovascular Pathology ◽

Score Index

The present study included a total of 96 patients with long-lasting type 1 diabetes mellitus (DM1) and early (0-5) stages of chronic renal disease (CRD). Replacement renal therapy (RRT) consisted of programmed hemodialysis (PHD) and kidney transplantation (KT). Routine clinical examination was supplemented by the assessment of phosphorous and calcium metabolism indices, measurement of cardiac pathology markers, and studies of coronary artery calcification with the use of multispiral computed tomography (MSCT) of the heart with the calculation of the Agatston score index. It was shown that the impairment of the renal function was accompanied by a rise in the phosphorus, parathormone, and FGF-23 levels, increased vitamin D deficiency (with a slight deviation of its levels from the reference values in the patients at high risk of cardiovascular events treated with PHD). In the patients who had undergone KT and showed fairly good function of the renal transplant, the above parameters were similar to those of the patients with stage 0-4 CRD which suggested their normalization in case of adequate RRT during DM1. The progress of cardiovascular pathology with the deterioration of the renal function was manifested as an increase of NT-proBNP levels in parallel to the duration of CRD (r=0.304; p<0.05), decrease of the glomerular filtration rate (p=-0.540; p<0.05), and their significant correlation with the main characteristics of mineral homeostasis. The degree of coronary artery calcification was related to the patients' age, duration of DM1, and severity of arterial hypertension. The high Agatston score index and pronounced left ventricular hypertrophy in the patients following KT are supposed to reflect the irreversible character of certain cardiovascular lesions persisting despite optimal RRT and positive dynamics of phosphorus and calcium metabolism and NT-proBNP levels. It is concluded that the development and progression of renal dysfunction are associated with the disturbances of mineral and bone metabolism that promote further progress of cardiovascular pathology that is the main cause of mortality among this cohort of patients.

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Relationship of coronary artery calcification with renal function decline and mortality in predialysis chronic kidney disease patients

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy183 ◽

2018 ◽

Vol 34 (10) ◽

pp. 1715-1722 ◽

Cited By ~ 2

Author(s):

Michelle C Lamarche ◽

Wilma M Hopman ◽

Jocelyn S Garland ◽

Christine A White ◽

Rachel M Holden

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Coronary Artery ◽

Kidney Disease ◽

Coronary Artery Calcification ◽

Mineral And Bone Disorder ◽

Renal Function Decline ◽

Urine Albumin ◽

End Stage ◽

Relationship Of

Abstract Background Patients with chronic kidney disease (CKD) have higher levels of coronary artery calcification (CAC) compared with the general population. The role of CAC in renal function decline is not well understood. Methods In this prospective cohort study of Stages 3–5 CKD patients with CAC scores kidney function decline, development of end-stage kidney disease (ESKD) and all-cause mortality were determined at 5 and 10 years. Baseline variables included markers of CKD and chronic kidney disease mineral and bone disorder (CKD-MBD), demographics and comorbidities. Multivariable analyses identified predictors of outcomes, and survival curves demonstrated the association of CAC score with ESKD and mortality. Results One hundred and seventy-eight patients were enrolled between 2005 and 2007. Independent predictors of ESKD at 5 years were estimated glomerular filtration rate (eGFR) and urine albumin–creatinine ratio (UACR); at 10 years, eGFR was no longer a predictor, but CAC was now significant. Those who developed ESKD at the fastest rate either had the highest CAC score (≥400 AU) or were youngest and had the lowest calcidiol, and highest serum phosphate, UACR and percentage change in CAC per year. Predictors of eGFR decline over 5 years were UACR, parathyroid hormone and CAC score. Predictors of mortality at 5 years were age, diabetes and eGFR and at 10 years also included CAC score. Conclusions In Stages 3–5 CKD patients, CAC is an independent predictor of both ESKD and mortality at 10 years. Those who developed ESKD at the fastest rate either had the highest CAC score or the worst CKD-MBD derangements.

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