title: Cardiovascular risk markers associated with arterial calcification in patients with chronic kidney disease Stages 3 and 4.
abstract: BACKGROUND
  The contribution of pro-inflammatory markers to cardiovascular (CV) risk and vascular calcification in chronic kidney disease (CKD) remains largely to be elucidated. We investigated the association between plasma levels of several biomarkers and calcification volume in three different vascular beds in CKD Stages 3 and 4 patients.
  
  
  METHODS
  This is a cross-sectional, exploratory study in patients with an estimated glomerular filtration rate (eGFR) ≥20 and ≤45 mL/min/1.73 m2and serum phosphorus ≥3.5 and <6.0 mg/dL enrolled in a previously published randomized, double blind, placebo-controlled single-centre trial. Ethylenediaminetetraacetic acid (EDTA) plasma samples were collected at baseline before patients received study medication and analysed for the presence of a number of biomarkers. Coronary artery calcium (CAC), thoracic aortic calcification (TAC) and abdominal aortic calcification (AAC) volumes were measured using standard electron-beam computed tomography protocols. Associations were adjusted for age, sex, smoking, body mass index, diabetes mellitus status, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure and eGFR.
  
  
  RESULTS
  Associations with CAC were found for β2-microglobulin (B2M), fibroblast growth factor 23 (FGF23), interleukin-8 (IL-8) and IL-18. AAC was associated with: B2M, FGF23 and IL-2 receptor alpha (IL-2 RA). TAC was associated with: B2M, FGF23, IL-2 RA, IL-18 and tumour necrosis factor receptor type I. For most of the analysed biomarkers, there were non-significant trends of associations with calcification.
  
  
  CONCLUSIONS
  This exploratory study found that elevated plasma levels of several inflammatory biomarkers are significantly associated with arterial calcification in CKD Stages 3 and 4 patients. A greater understanding of inflammation and calcification in CKD patients may help the development of CV risk-assessment algorithms for better management of these patients.
authors.affiliation: Cardiovascular and Metabolism Disease Therapeutic Area , F. Hoffmann-La Roche Ltd , Basel , Switzerland.
authors.forename: Chek Ing
authors.initials: CI
authors.lastname: Kiu Weber
authors.affiliation: Non-Clinical Safety , F. Hoffmann-La Roche Ltd , Basel , Switzerland.
authors.forename: Guillemette
authors.initials: G
authors.lastname: Duchateau-Nguyen
authors.affiliation: Non-Clinical Safety , F. Hoffmann-La Roche Ltd , Basel , Switzerland.
authors.forename: Corinne
authors.initials: C
authors.lastname: Solier
authors.affiliation: Non-Clinical Safety , F. Hoffmann-La Roche Ltd , Basel , Switzerland.
authors.forename: Annette
authors.initials: A
authors.lastname: Schell-Steven
authors.affiliation: Cardiovascular and Metabolism Disease Therapeutic Area , F. Hoffmann-La Roche Ltd , Basel , Switzerland.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Hermosilla
authors.affiliation: Cardiovascular and Metabolism Disease Therapeutic Area , F. Hoffmann-La Roche Ltd , Basel , Switzerland.
authors.forename: Everson
authors.initials: E
authors.lastname: Nogoceke
authors.affiliation: Denver Nephrology , Clinical Research , Denver, CO , USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Block
keywords: arterial calcification; biomarkers; cardiovascular risk; chronic kidney disease; inflammation