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Relationships between abdominal aortic calcification, glomerular filtration rate, and cardiovascular risk factors in patients with non-dialysis dependent chronic kidney disease

Zhou, Yunan LU ; Hellberg, Matthias LU ; Kouidi, Evangelia; Deligiannis, Asterios; Höglund, Peter LU and Clyne, Naomi LU (2018) In Clinical Nephrology 90(6). p.380-389
Abstract

Background: Abdominal aortic calcification (AAC) is an established risk factor for cardiovascular events in patients with chronic kidney disease (CKD). We hypothesized that AAC is associated with a decline in glomerular filtration rate (GFR) as well as with some other cardiovascular risk factors. Materials and methods: This is a cross-sectional analysis of baseline data from a randomized controlled clinical trial (RENEXC). A total of 151 patients (aged 66 ± 14 years) with an average measured GFR (mGFR) of 22.5 ± 8.2 mL/min/1.73m2, not on renal replacement therapy, irrespective of number of comorbidities, were included. GFR was measured with iohexol clearance and estimated using cystatin C- and creatinine-based equations... (More)

Background: Abdominal aortic calcification (AAC) is an established risk factor for cardiovascular events in patients with chronic kidney disease (CKD). We hypothesized that AAC is associated with a decline in glomerular filtration rate (GFR) as well as with some other cardiovascular risk factors. Materials and methods: This is a cross-sectional analysis of baseline data from a randomized controlled clinical trial (RENEXC). A total of 151 patients (aged 66 ± 14 years) with an average measured GFR (mGFR) of 22.5 ± 8.2 mL/min/1.73m2, not on renal replacement therapy, irrespective of number of comorbidities, were included. GFR was measured with iohexol clearance and estimated using cystatin C- and creatinine-based equations (eGFR). AAC was evaluated with lateral lumbar X-ray using the scoring system described by Kauppila. All patients underwent laboratory analyses, 24-hour ambulatory blood pressure monitoring, and standard echocardiography. Multiple linear regression analyses controlling for sex, age, cardiovascular comorbidities, and hypertension were performed. Results: The prevalence of AAC in this group of patients was 73%, and 47% had severe calcification (AAC score ≥ 7). More men (76%) had AAC than women (69%). AAC score was associated with mGFR (p = 0.03), eGFR (p = 0.006), plasma albumin (p = 0.006), plasma phosphate (p = 0.01), pulse pressure (p = 0.004), left ventricular mass (LVM) (p = 0.02), left atrial volume (LAV; p < 0.001), and left atrial volume index (LAVI; p = 0.001). Conclusion: AAC was highly prevalent in CKD. The degree of calcification in the abdominal aorta was strongly associated with a decline in GFR, a decrease in plasma albumin, an increase in plasma phosphate, an increase in pulse pressure, and cardiac structural changes, such as an increase in LVM, LAV, and LAVI.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal aortic calcification (AAC), Cardiovascular disease, Chronic kidney disease (CKD), Echocardiographic index, Glomerular filtration rate (GFR), Pulse pressure
in
Clinical Nephrology
volume
90
issue
6
pages
10 pages
publisher
Dustri-Verlag
external identifiers
  • scopus:85056661650
ISSN
0301-0430
DOI
10.5414/CN109441
language
English
LU publication?
yes
id
bbef4bad-c4fa-42b8-887d-15ec371d22a8
date added to LUP
2018-11-26 13:45:51
date last changed
2019-04-05 13:03:36
@article{bbef4bad-c4fa-42b8-887d-15ec371d22a8,
  abstract     = {<p>Background: Abdominal aortic calcification (AAC) is an established risk factor for cardiovascular events in patients with chronic kidney disease (CKD). We hypothesized that AAC is associated with a decline in glomerular filtration rate (GFR) as well as with some other cardiovascular risk factors. Materials and methods: This is a cross-sectional analysis of baseline data from a randomized controlled clinical trial (RENEXC). A total of 151 patients (aged 66 ± 14 years) with an average measured GFR (mGFR) of 22.5 ± 8.2 mL/min/1.73m<sup>2</sup>, not on renal replacement therapy, irrespective of number of comorbidities, were included. GFR was measured with iohexol clearance and estimated using cystatin C- and creatinine-based equations (eGFR). AAC was evaluated with lateral lumbar X-ray using the scoring system described by Kauppila. All patients underwent laboratory analyses, 24-hour ambulatory blood pressure monitoring, and standard echocardiography. Multiple linear regression analyses controlling for sex, age, cardiovascular comorbidities, and hypertension were performed. Results: The prevalence of AAC in this group of patients was 73%, and 47% had severe calcification (AAC score ≥ 7). More men (76%) had AAC than women (69%). AAC score was associated with mGFR (p = 0.03), eGFR (p = 0.006), plasma albumin (p = 0.006), plasma phosphate (p = 0.01), pulse pressure (p = 0.004), left ventricular mass (LVM) (p = 0.02), left atrial volume (LAV; p &lt; 0.001), and left atrial volume index (LAVI; p = 0.001). Conclusion: AAC was highly prevalent in CKD. The degree of calcification in the abdominal aorta was strongly associated with a decline in GFR, a decrease in plasma albumin, an increase in plasma phosphate, an increase in pulse pressure, and cardiac structural changes, such as an increase in LVM, LAV, and LAVI.</p>},
  author       = {Zhou, Yunan and Hellberg, Matthias and Kouidi, Evangelia and Deligiannis, Asterios and Höglund, Peter and Clyne, Naomi},
  issn         = {0301-0430},
  keyword      = {Abdominal aortic calcification (AAC),Cardiovascular disease,Chronic kidney disease (CKD),Echocardiographic index,Glomerular filtration rate (GFR),Pulse pressure},
  language     = {eng},
  number       = {6},
  pages        = {380--389},
  publisher    = {Dustri-Verlag},
  series       = {Clinical Nephrology},
  title        = {Relationships between abdominal aortic calcification, glomerular filtration rate, and cardiovascular risk factors in patients with non-dialysis dependent chronic kidney disease},
  url          = {http://dx.doi.org/10.5414/CN109441},
  volume       = {90},
  year         = {2018},
}