Incidence and progression of coronary calcification in chronic kidney disease: the Multi-Ethnic Study of Atherosclerosis.
We studied the incidence and progression of coronary artery calcification in people with early chronic kidney disease. We used a cohort of 562 adult patients with chronic kidney disease who had an estimated glomerular filtration rate of <60 ml/min/1.73 m(2), in a community-based study of people without clinical cardiovascular disease, the Multi-Ethnic Study of Atherosclerosis. The majority had stage 3 disease. Coronary artery calcification was measured at baseline and again approximately 1.6 or 3.2 years later. The prevalence of coronary artery calcification at baseline was 66%, and its adjusted prevalence was 24% lower in African Americans as compared to Caucasians. The incidence of coronary artery calcification was 6.1% per year in women and 14.8% in men. Coronary artery calcification progressed in approximately 17% of subjects per year across all subgroups, and diabetes was associated with a 65% greater adjusted risk of progression. Male gender and diabetes were the only factors associated with adjusted coronary artery calcification incidence and progression, respectively. Our study shows that coronary artery calcification is common in people with stage 3 disease, progresses rapidly, and may contribute to cardiovascular risk.
Kestenbaum
Bryan R
BR
Division of Nephrology, Department of Medicine, Harborview Medical Center, Kidney Research Institute, University of Washington, Seattle, Washington 98104-2499, USA. brk@u.washington.edu
Adeney
Kathryn L
KL
de Boer
Ian H
IH
Ix
Joachim H
JH
Shlipak
Michael G
MG
Siscovick
David S
DS
D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002114:Calcinosis / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology*; D002908:Chronic Disease; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology*; D048909:Diabetes Complications / Q000208:ethnology / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
J Am Coll Cardiol. 2007 Sep 4;50(10):953-60
17765122
J Am Soc Nephrol. 2005 Jul;16(7):2205-15
15917335
Osteoporos Int. 2008 Aug;19(8):1161-6
18180973
Ann Intern Med. 1999 Mar 16;130(6):461-70
10075613
J Am Soc Nephrol. 2008 Mar;19(3):579-85
18235089
Am Heart J. 2007 Feb;153(2):328-34
17239697
J Am Coll Cardiol. 1990 Mar 15;15(4):827-32
2407762
Hypertension. 2001 Oct;38(4):938-42
11641313
J Am Coll Cardiol. 2007 May 22;49(20):2013-20
17512357
J Clin Endocrinol Metab. 1989 Oct;69(4):762-70
2778034
J Am Coll Cardiol. 2002 Feb 20;39(4):695-701
11849871
Clin J Am Soc Nephrol. 2007 Jan;2(1):121-34
17699396
Hypertension. 2005 Jul;46(1):38-43
15956113
Hypertens Res. 2008 Jun;31(6):1163-70
18716364
J Am Soc Nephrol. 2009 Feb;20(2):381-7
19073826
Kidney Int. 2005 Jul;68(1):271-7
15954917
N Engl J Med. 2008 Mar 27;358(13):1336-45
18367736
J Bone Miner Res. 1995 May;10(5):782-7
7639113
Am J Cardiol. 2006 Sep 1;98(5):571-6
16923438
N Engl J Med. 2000 May 18;342(20):1478-83
10816185
Kidney Int. 2005 Oct;68(4):1815-24
16164659
Am J Epidemiol. 2002 Nov 1;156(9):871-81
12397006
AJR Am J Roentgenol. 2008 Feb;190(2):W87-92
18212206
Clin J Am Soc Nephrol. 2008 Sep;3(5):1391-7
18550650
Am J Cardiol. 2003 Sep 1;92(5):498-503
12943866
Diabetes Care. 2003 Nov;26(11):3160-7
14578255
Kidney Int. 2007 Mar;71(5):438-41
17200680
Hum Genet. 2007 Jun;121(5):565-75
17356887
Radiology. 2005 Aug;236(2):477-84
15972340
Clin J Am Soc Nephrol. 2009 Mar;4(3):609-15
19211667
Kidney Int. 2002 Feb;61(2):638-47
11849407
Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266
11904577
J Am Soc Nephrol. 2005 Feb;16(2):507-13
15601745
Kidney Int. 2002 Jul;62(1):245-52
12081584
Nephrol Dial Transplant. 2006 Sep;21(9):2464-71
16735378
Kidney Int. 2006 Jan;69(2):399-405
16408133
Radiology. 2005 Jan;234(1):35-43
15618373
Am J Kidney Dis. 2004 Dec;44(6):1024-30
15558523
Kidney Int. 2007 Jan;71(1):31-8
17091124