title: Relationship of estimated GFR and coronary artery calcification in the CRIC (Chronic Renal Insufficiency Cohort) Study.
abstract: BACKGROUND
  Coronary artery calcification (CAC) is associated with increased mortality risk in the general population. Although individuals with chronic kidney disease (CKD) are at markedly increased mortality risk, the incidence, prevalence, and prognosis of CAC in CKD are not well understood.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Analysis of 1,908 participants who underwent coronary calcium scanning as part of the multiethnic CRIC (Chronic Renal Insufficiency Cohort) Study.
  
  
  METHODS
  Estimated glomerular filtration rate (eGFR) computed using the Modification of Diet in Renal Disease (MDRD) Study equation, stratified by race, sex, and diabetic status. eGFR was treated as a continuous and a categorical variable compared with the reference value of >60 mL/min/1.73 m(2).
  
  
  METHODS
  CAC detected using computed tomography (CT) using either an Imatron C-300 electron beam computed tomography (CT) scanner or multidetector CT scanner. CAC was computed using Agatston score as a categorical variable. Analyses were performed using ordinal logistic regression.
  
  
  RESULTS
  We found a strong and graded relationship between lower eGFR and increasing CAC. In unadjusted models, ORs increased from 1.68 (95% CI, 1.23-2.31) for eGFR of 50-59 mL/min/1.73 m(2) to 2.82 (95% CI, 2.06-3.85) for eGFR <30 mL/min/1.73 m(2). Multivariable adjustment only partially attenuated the results (OR, 1.53; 95% CI, 1.07-2.20) for eGFR <30 mL/min/1.73 m(2).
  
  
  CONCLUSIONS
  Use of eGFR rather than measured GFR.
  
  
  CONCLUSIONS
  We showed a graded relationship between severity of CKD and CAC independent of traditional risk factors. These findings support recent guidelines that state that if vascular calcification is present, it should be considered as a complementary component to be included in the decision making required for individualizing CKD treatment.
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA. mbudoff@labiomed.org
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rader
authors.forename: Muredach P
authors.initials: MP
authors.lastname: Reilly
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
authors.forename: Jim
authors.initials: J
authors.lastname: Lash
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Leigh
authors.initials: L
authors.lastname: Rosen
authors.forename: Melanie
authors.initials: M
authors.lastname: Glenn
authors.forename: Valerie
authors.initials: V
authors.lastname: Teal
authors.forename: Harold I
authors.initials: HI
authors.lastname: Feldman
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002118:Calcium / Q000032:analysis; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000378:metabolism; D005006:Ethnicity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000378:metabolism; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States / Q000453:epidemiology
chemical_list: D002118:Calcium