title: Impact of Renal Functional/Morphological Dynamics on the Calcification of Coronary and Abdominal Arteries in Patients with Chronic Kidney Disease.
abstract: OBJECTIVE
  Fast-progressing vascular calcification (VC) is accompanied by renal atrophy and functional deterioration along with atherosclerosis in patients with chronic kidney disease (CKD). However, the relationship between VC progression and renal functional and/or morphological changes remains unclear.
  
  
  METHODS
  We included 70 asymptomatic patients with CKD without hemodialysis in our study. To identify temporal variations, the coronary artery calcification score (CACS), abdominal aortic calcification index (ACI), and renal parenchymal volume index (RPVI) were determined via spiral computed tomography scans taken during the study. We investigated significant factors related to annualized variations of CACS (ΔCACS/y) and ACI (ΔACI/y).
  
  
  RESULTS
  During the follow-up period (4.6 years), median values of CACS [in Agatston units (AU)] and ACI increased from 40.2 to 113.3 AU (p=0.053) and from 13.2 to 21.7% (p=0.036), respectively. Multivariate analysis revealed that CACS at baseline (p＜0.001) and diabetes mellitus (DM) status (p=0.037) for ΔCACS/y and ACI at baseline (p=0.017) and hypertension (HT) status (p= 0.046) for ΔACI/y were significant independent predictors. Furthermore, annualized RPVI variation was significantly related to both ΔCACS/y and ΔACI/y (R=-0.565, p＜0.001, and R=-0.289, p=0.015, respectively). On the other hand, independent contributions of the estimated glomerular filtration rate (eGFR) and annualized eGFR variation to VC progression were not confirmed.
  
  
  CONCLUSIONS
  The degree of VC at baseline, DM, HT, and changes in renal volume, but not eGFR, had a strong impact on VC progression in patients with CKD.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Takeo
authors.initials: T
authors.lastname: Ichii
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.|Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine.
authors.forename: Ryota
authors.initials: R
authors.lastname: Morimoto
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okumura
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tatami
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Dai
authors.initials: D
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Aoki
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hiraiwa
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Kenji
authors.initials: K
authors.lastname: Furusawa
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Toru
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Kano
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukaya
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Akinori
authors.initials: A
authors.lastname: Sawamura
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000473:pathology; D012307:Risk Factors; D061205:Vascular Calcification / Q000209:etiology* / Q000473:pathology
keywords: Abdominal aortic calcification index; Chronic kidney disease; Coronary artery calcification; Renal parenchymal volume