Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly

J Am Heart Assoc. 2021 Jul 6;10(13):e019300. doi: 10.1161/JAHA.120.019300. Epub 2021 Jun 19.

Abstract

Background The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS). Methods and Results Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m2) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5-8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted-β, -0.40; 95% CI, -0.80 to -0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13-5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance (P=0.004). Conclusions Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.

Keywords: chronic kidney disease; coronary artery calcium; renal function; risk factor; vascular calcification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging*
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiopathology
  • Linear Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / physiopathology
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Tomography, X-Ray Computed*
  • Vascular Calcification / complications
  • Vascular Calcification / diagnostic imaging*
  • Young Adult