Predictors of abdominal aortic calcification progression in patients with chronic kidney disease without hemodialysis. (October 2016)

• Record Type: Journal Article
• Authors: Yamamoto, Dai; Suzuki, Susumu; Ishii, Hideki; Hirayama, Kenshi; Harada, Kazuhiro; Aoki, Toshijiro; Shibata, Yohei; Negishi, Yosuke; Tatami, Yosuke; Sumi, Takuya; Ichii, Takeo; Kawashima, Kazuhiro; Kunimura, Ayako; Kawamiya, Toshiki; Morimoto, Ryota; Yasuda, Yoshinari; Murohara, Toyoaki
• Is Part Of: Atherosclerosis. Volume 253(2016)
• Page Start: 15
• Page End: 21
• Publication Date: 2016-10
• Subjects: Chronic kidney disease -- Progression of aortic calcification -- Abdominal aortic calcification index -- Parathyroid hormone -- Pulse pressure; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2016.08.004
• Languages: English
• ISSNs: 0021-9150

Abstract

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 m 2 ] 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 m 2 ) 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 m 2 ). 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. Highlights: We investigated that risk factors associated with abdominal aortic calcification (AAC) progression in each eGFR grades. The AAC progression rate was significantly accelerated in patients with advanced chronic kidney disease (CKD). The risk factors for AAC progression differed among each eGFR grades. The only significant risk factor for mild to moderate CKD patients was pulse pressure level. The significant risk factor for advanced CKD patients was parathyroid hormone levels.