title: Predictors of abdominal aortic calcification progression in patients with chronic kidney disease without hemodialysis.
abstract: Abdominal aortic calcification (AAC) is an important predictor of cardiovascular mortality in patients with chronic kidney disease (CKD). However, little is known regarding AAC progression in these patients. This study aimed to identify risk factors associated with AAC progression in patients with CKD without hemodialysis.
  
  
  
  We recruited 141 asymptomatic patients with CKD without hemodialysis [median estimated glomerular filtration rate (eGFR), 40.3 mL/min/1.73 m2] and evaluated the progression of the abdominal aortic calcification index (ACI) over 3 years. To identify risk factors contributing to the rate of ACI progression, the associations between baseline clinical characteristics and annual change in ACI for each CKD category were analyzed. The annual change of ACI (ΔACI/year) was calculated as follows: (second ACI - first ACI)/duration between the two evaluations.
  
  
  
  Median ΔACI/year values significantly increased in advanced CKD stages (0.73%, 0.87%, and 2.24%/year for CKD stages G1-2, G3, and G4-5, respectively; p for trend = 0.041). The only independent risk factor for AAC progression in mild to moderate CKD (G1-3, eGFR ≥ 30 mL/min/1.73 m2) was pulse pressure level (β = 0.258, p = 0.012). In contrast, parathyroid hormone (PTH) level was significantly correlated with ΔACI/year (β = 0.426, p = 0.007) among patients with advanced CKD (G4-5, eGFR < 30 mL/min/1.73 m2).
  
  
  
  This study suggests that the AAC progression rate was significantly accelerated in patients with advanced CKD. In addition, measuring PTH is useful to evaluate both bone turnover and AAC progression in patients with advanced CKD.
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Dai
authors: D
authors: Yamamoto
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: susumusuzuki@med.nagoya-u.ac.jp.
authors: Susumu
authors: S
authors: Suzuki
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Hideki
authors: H
authors: Ishii
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Kenshi
authors: K
authors: Hirayama
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Kazuhiro
authors: K
authors: Harada
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Toshijiro
authors: T
authors: Aoki
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yohei
authors: Y
authors: Shibata
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yosuke
authors: Y
authors: Negishi
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yosuke
authors: Y
authors: Tatami
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Takuya
authors: T
authors: Sumi
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Takeo
authors: T
authors: Ichii
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Kazuhiro
authors: K
authors: Kawashima
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Ayako
authors: A
authors: Kunimura
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Toshiki
authors: T
authors: Kawamiya
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Ryota
authors: R
authors: Morimoto
authors: Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yoshinari
authors: Y
authors: Yasuda
authors: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Toyoaki
authors: T
authors: Murohara
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology*; D001018:Aortic Diseases / Q000150:complications / Q000503:physiopathology*; D001794:Blood Pressure; D002114:Calcinosis / Q000150:complications / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000379:methods; D012307:Risk Factors; D061205:Vascular Calcification / Q000503:physiopathology
chemical_list: D010281:Parathyroid Hormone
keywords: Abdominal aortic calcification index; Chronic kidney disease; Parathyroid hormone; Progression of aortic calcification; Pulse pressure