title: Renal artery calcium, cardiovascular risk factors, and indexes of renal function.
abstract: Vascular calcium is well studied in the coronary and peripheral arteries, although there are limited data focusing on calcium deposits specific to renal arteries. The associations among renal artery calcium (RAC), cardiovascular disease risk factors, and indexes of renal function are unknown. We examined 2,699 Framingham Heart Study participants who were part of a multidetector computed tomography substudy from 2008 to 2011. RAC was measured as a calcified plaque of >130 HU and an area of >3 contiguous pixels. Detectable RAC was defined as an Agatston score >0. Chronic kidney disease was defined as an estimated glomerular filtration rate of <60 ml/min/1.73 m(2). Microalbuminuria was defined as an albumin/creatinine ratio of ≥17 mg/g for men and ≥25 mg/g for women. Multivariable adjusted logistic regression models were used to evaluate the associations between RAC, cardiovascular disease risk factors, and renal function. The associations were secondarily adjusted for coronary artery calcium (CAC) that was used as a marker of nonrenal systemic vascular calcium. The prevalence of RAC was 28.2%; this was similar in women (28.8%) and men (27.5%). Patients with RAC had a higher odds of microalbuminuria (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.22 to 2.61, p = 0.003), hypertension (OR 2.11, 95% CI 1.69 to 2.64, p <0.001), and diabetes (OR 1.60, 95% CI 1.14 to 2.24, p = 0.01) but not chronic kidney disease (OR 0.87, 95% CI 0.58 to 1.32). After adjustment for CAC, the association with microalbuminuria and hypertension persisted, but the association with diabetes became nonsignificant. In conclusion, RAC is common and independently associated with microalbuminuria and hypertension after adjustment for nonrenal vascular calcium. RAC may be uniquely associated with these markers of renal end-organ damage.
authors.affiliation: Renal Section, Boston University Medical Center, Boston, Massachusetts.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Roseman
authors.affiliation: Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts; Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Hwang
authors.affiliation: Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Manders
authors.affiliation: Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts; Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland; Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.affiliation: Renal Section, Boston University Medical Center, Boston, Massachusetts.
authors.forename: Ashish
authors.initials: A
authors.lastname: Upadhyay
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts; Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: foxca@nhlbi.nih.gov.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009511:New England / Q000453:epidemiology; D012077:Renal Artery / Q000000981:diagnostic imaging*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors