TY - JOUR

T1 - Regional distribution and severity of arterial calcification in patients with chronic kidney disease stages 1-5

T2 - a cross-sectional study of the Copenhagen chronic kidney disease cohort

AU - Sorensen, Ida Maria Hjelm

AU - Saurbrey, Sasha Asboll Kepler

AU - Hjortkjaer, Henrik Oder

AU - Brainin, Philip

AU - Carlson, Nicholas

AU - Ballegaard, Ellen Linnea Freese

AU - Kamper, Anne-Lise

AU - Christoffersen, Christina

AU - Feldt-Rasmussen, Bo

AU - Kofoed, Klaus Fuglsang

AU - Bro, Susanne

PY - 2020

Y1 - 2020

N2 - BackgroundPatients with chronic kidney disease (CKD) and arterial calcification are considered at increased risk of adverse cardiovascular outcomes. However, the optimal site for measurement of arterial calcification has not been determined. The primary aim of this study was to examine the pattern of arterial calcification in different stages of CKD.MethodsThis was an observational, cross-sectional study that included 580 individuals with CKD stages 1-5 (no dialysis) from the Copenhagen CKD Cohort. Calcification of the carotid, coronary and iliac arteries, thoracic and abdominal aorta was assessed using non-contrast multidetector computed tomography scans and quantified according to the Agatston method. Based on the distribution of Agatston scores in the selected arterial region, the subjects were divided into calcium score categories of 0 (no calcification), 1-100, 101-400 and>400.ResultsParticipants with CKD stages 3-5 had the highest prevalence of calcification and the highest frequency of calcium scores >400 in all arterial sites. Calcification in at least one arterial site was present in >90% of patients with CKD stage 3. In all five CKD stages prevalence of calcification was greatest in both the thoracic and abdominal aorta, and in the iliac arteries. These arterial sites also showed the highest calcium scores. High calcium scores (>400) in all five arterial regions were independently associated with prevalent cardiovascular disease. In multivariable analyses, after adjusting for cardiovascular risk factors, declining creatinine clearance was associated with increasing calcification of the coronary arteries (p=0.012) and the thoracic aorta (p=0.037) only.ConclusionsArterial calcification is highly prevalent throughout all five CKD stages and is most prominent in both the thoracic and abdominal aorta, and in the iliac arteries. Follow-up studies are needed to explore the potential of extracardiac calcification sites in prediction of cardiovascular events in the CKD population.

AB - BackgroundPatients with chronic kidney disease (CKD) and arterial calcification are considered at increased risk of adverse cardiovascular outcomes. However, the optimal site for measurement of arterial calcification has not been determined. The primary aim of this study was to examine the pattern of arterial calcification in different stages of CKD.MethodsThis was an observational, cross-sectional study that included 580 individuals with CKD stages 1-5 (no dialysis) from the Copenhagen CKD Cohort. Calcification of the carotid, coronary and iliac arteries, thoracic and abdominal aorta was assessed using non-contrast multidetector computed tomography scans and quantified according to the Agatston method. Based on the distribution of Agatston scores in the selected arterial region, the subjects were divided into calcium score categories of 0 (no calcification), 1-100, 101-400 and>400.ResultsParticipants with CKD stages 3-5 had the highest prevalence of calcification and the highest frequency of calcium scores >400 in all arterial sites. Calcification in at least one arterial site was present in >90% of patients with CKD stage 3. In all five CKD stages prevalence of calcification was greatest in both the thoracic and abdominal aorta, and in the iliac arteries. These arterial sites also showed the highest calcium scores. High calcium scores (>400) in all five arterial regions were independently associated with prevalent cardiovascular disease. In multivariable analyses, after adjusting for cardiovascular risk factors, declining creatinine clearance was associated with increasing calcification of the coronary arteries (p=0.012) and the thoracic aorta (p=0.037) only.ConclusionsArterial calcification is highly prevalent throughout all five CKD stages and is most prominent in both the thoracic and abdominal aorta, and in the iliac arteries. Follow-up studies are needed to explore the potential of extracardiac calcification sites in prediction of cardiovascular events in the CKD population.

KW - Chronic kidney disease

KW - Cardiovascular disease

KW - Vascular calcification

KW - Arterial calcification

KW - Calcium score

KW - Carotid arteries

KW - Coronary arteries

KW - Thoracic aorta

KW - Abdominal aorta

KW - Iliac arteries

KW - CALCIFIED ATHEROSCLEROSIS

KW - VASCULAR CALCIFICATION

KW - RISK MARKERS

KW - CALCIUM

KW - DEATH

KW - QUANTIFICATION

KW - IMPROVEMENT

KW - SCORE

KW - BEDS

U2 - 10.1186/s12882-020-02192-y

DO - 10.1186/s12882-020-02192-y

M3 - Journal article

C2 - 33297991

VL - 21

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 534

ER -