Quantitative analysis of abdominal aortic calcification in CKD patients without dialysis therapy by use of the Agatston score

Kidney Blood Press Res. 2013;38(2-3):196-204. doi: 10.1159/000355768. Epub 2014 Apr 8.

Abstract

Background/aim: The aim of the present study was to quantitatively examine factors associated with aortic calcification in non-dialysis CKD patients.

Methods: We quantitatively investigated aortic calcification from the renal artery to the bifurcation in 149 non-dialysis CKD patients (58±16 years; 96 males and 53 females, 48 diabetics; eGFR 40.3 ± 29.3 ml/min), and measured Agatston scores using multi-slice computed tomography.

Result: Of 149 patients, aortic calcification was present in 117. In patients with aortic calcification, age (p<0.001), C-reactive protein (p<0.001), and intact-PTH (p < 0.001) were significantly higher, estimated glomerular filtration rate (eGFR) was significantly lower (p<0.001), and diabetes was observed more often (p<0.05). In regards to the degree of aortic calcification, the Agatston scores correlated significantly and positively with age (ρ=0.438, p<0.001) and serum phosphate (ρ=0.208, p=0.024), and correlated significantly but negatively with e-GFR (ρ=-0.353, p<0.001). In multiple regression analysis, eGFR was associated significantly and independently with the log [Agatston score] (β=-0.346, p<0.01), after adjustment for several confounders including serum phosphate and the presence of diabetes.

Conclusions: Hyperphospatemia, chronic inflammation, diabetes, and decreased GFR are associated significantly with the presence of aortic calcification in non-dialysis CKD patients. Decreased eGFR was associated significantly and independently with the quantitative degree of aortic calcification.

MeSH terms

  • Adult
  • Aged
  • Aorta, Abdominal / diagnostic imaging*
  • Calcinosis / diagnostic imaging*
  • Calcinosis / etiology
  • Diabetic Nephropathies / diagnostic imaging
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension, Renal / complications
  • Male
  • Middle Aged
  • Renal Dialysis
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnostic imaging*
  • Renal Insufficiency, Chronic / physiopathology
  • Tomography, X-Ray Computed