title: The risk for medial arterial calcification in CKD.
abstract: OBJECTIVE
  CKD is a risk factor for medial artery calcification, but the CKD stage at which this risk begins is unknown. Because breast arterial calcification (BAC) is a marker of generalized medial arterial calcification, mammography was used to detect medial arterial calcification in women with different CKD stages.
  
  
  METHODS
  This was a retrospective, cross-sectional study of women with and without CKD matched for age and diabetes and identified from mammograms obtained in 2006-2011. BAC was scored as present or absent per visual inspection.
  
  
  RESULTS
  A total of 146 women with stage 3 CKD and 54 with stage 4/5 CKD were identified. An additional 21 patients with ESRD were identified and added to a previous cohort of 71 patients. Mean age was 64 years for CKD 3, 63 for CKD 4, and 59 for ESRD. Half of each group had diabetes. Compared with controls, the odds ratios for BAC were 1.44 in CKD 3 (95% confidence interval [CI], 0.82-2.53), 2.69 in CKD 4 (95% CI, 1.14-6.33), and 7.19 in ESRD (95% CI, 3.77-13.7) and did not differ with diabetic status or race. In a multivariable logistic model, age (P<0.001) and estimated GFR (P=0.005) were independent predictors of BAC. The odds ratio for BAC increased 4% for each milliliter per minute per 1.73 m(2) decrease in estimated GFR. The prevalence of BAC in CKD was increased in each decade of age over 49 years.
  
  
  CONCLUSIONS
  CKD is an independent risk factor for medial arterial calcification.
authors.affiliation: Renal Division, Emory University School of Medicine, Atlanta, GA 30322, USA.
authors.forename: Nada Abou
authors.initials: NA
authors.lastname: Hassan
authors.forename: Ellen T
authors.initials: ET
authors.lastname: D'Orsi
authors.forename: Carl J
authors.initials: CJ
authors.lastname: D'Orsi
authors.forename: W Charles
authors.initials: WC
authors.lastname: O'Neill
mesh_terms: D001940:Breast / Q000098:blood supply*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017540:Tunica Media / Q000000981:diagnostic imaging; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*