Regional distribution and severity of arterial calcification in patients with chronic kidney disease stages 1-5: a cross-sectional study of the Copenhagen chronic kidney disease cohort.

Autor: Sørensen IMH; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark. ida.maria.hjelm.soerensen@regionh.dk., Saurbrey SAK; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Hjortkjær HØ; Department of Cardiology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Brainin P; Department of Cardiology, Herlev and Gentofte University Hospital, Niels Andersens Vej 65, Post 835, DK-2900, Copenhagen, Denmark., Carlson N; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Ballegaard ELF; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Kamper AL; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Christoffersen C; Department of Clinical Biochemistry, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen, Denmark., Feldt-Rasmussen B; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Kofoed KF; Department of Cardiology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark., Bro S; Department of Nephrology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: BMC nephrology [BMC Nephrol] 2020 Dec 09; Vol. 21 (1), pp. 534. Date of Electronic Publication: 2020 Dec 09.
DOI: 10.1186/s12882-020-02192-y
Abstrakt: Background: Patients with chronic kidney disease (CKD) and arterial calcification are considered at increased risk of adverse cardiovascular outcomes. However, the optimal site for measurement of arterial calcification has not been determined. The primary aim of this study was to examine the pattern of arterial calcification in different stages of CKD.
Methods: This was an observational, cross-sectional study that included 580 individuals with CKD stages 1-5 (no dialysis) from the Copenhagen CKD Cohort. Calcification of the carotid, coronary and iliac arteries, thoracic and abdominal aorta was assessed using non-contrast multidetector computed tomography scans and quantified according to the Agatston method. Based on the distribution of Agatston scores in the selected arterial region, the subjects were divided into calcium score categories of 0 (no calcification), 1-100, 101-400 and > 400.
Results: Participants with CKD stages 3-5 had the highest prevalence of calcification and the highest frequency of calcium scores > 400 in all arterial sites. Calcification in at least one arterial site was present in > 90% of patients with CKD stage 3. In all five CKD stages prevalence of calcification was greatest in both the thoracic and abdominal aorta, and in the iliac arteries. These arterial sites also showed the highest calcium scores. High calcium scores (> 400) in all five arterial regions were independently associated with prevalent cardiovascular disease. In multivariable analyses, after adjusting for cardiovascular risk factors, declining creatinine clearance was associated with increasing calcification of the coronary arteries (p = 0.012) and the thoracic aorta (p = 0.037) only.
Conclusions: Arterial calcification is highly prevalent throughout all five CKD stages and is most prominent in both the thoracic and abdominal aorta, and in the iliac arteries. Follow-up studies are needed to explore the potential of extracardiac calcification sites in prediction of cardiovascular events in the CKD population.
Databáze: MEDLINE
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