title: Aortic arch calcification predicts the renal function progression in patients with stage 3 to 5 chronic kidney disease.
abstract: BACKGROUND
  The presence of aortic arch calcification (AoAC) and cardiomegaly on chest radiography has been demonstrated as important risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD). However, the interrelationship among AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC and cardiomegaly are independently associated with the renal function progression in patients with stages 3-5 CKD.
  
  
  METHODS
  We retrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without entering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal function was measured by the slope of estimated glomerular filtration rate (eGFR).
  
  
  RESULTS
  Of the 237 patients, the rate of eGFR decline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC and proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope, and cardiomegaly.
  
  
  CONCLUSIONS
  The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an independent determinant of renal outcomes in patients with CKD stages 3-5.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan.
authors.forename: Lung-Chih
authors.identifier: 0000-0002-1808-0083
authors.initials: LC
authors.lastname: Li
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan.
authors.forename: Yueh-Ting
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei 102, Taiwan ; Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
authors.forename: Yi-Wei
authors.identifier: 0000-0003-4346-4254
authors.initials: YW
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan.
authors.forename: Chia-An
authors.initials: CA
authors.lastname: Chou
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan.
authors.forename: Chien-Te
authors.initials: CT
authors.lastname: Lee
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology*; D002113:Calcification, Physiologic / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors