Kidney Week

Abstract: TH-OR024

Association of Serum Calcification Propensity with Presence and Progression of Coronary Artery Calcification among Patients with CKD: The CRIC Study

Session Information

• CKD-MBD: Phosphorus, FGF-23, and Trials
  October 25, 2018 | Location: 33C, San Diego Convention Center
  Abstract Time: 05:06 PM - 05:18 PM

Category: Bone and Mineral Metabolism

• 402 Bone and Mineral Metabolism: Clinical

Authors

• Bundy, Joshua David, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Joshua David Bundy, PhD, MPH



Josh is a Postdoctoral Fellow at Northwestern University Feinberg School of Medicine. His primary research interests include identification of novel risk factors for subclinical disease and targets for therapy in patients with chronic kidney disease, who are at high risk for cardiovascular disease. Josh is interested in testing new interventions in clinical trials and comparing the effectiveness of interventions using meta-analytic techniques. Additionally, he is interested in novel statistical approaches for evidence-based medicine, including use of new disease prediction methods and exploring the intersection of technology and disease prevention.

• Cai, Xuan, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Xuan Cai,

• Scialla, Julia J., Duke University, Durham, North Carolina, United States

Julia J. Scialla,

• Block, Geoffrey A., Colorado Kidney Care, Denver, Colorado, United States

Geoffrey A. Block,

• Feldman, Harold I., University of Pennsylvania School of Medicine, Villanova, Pennsylvania, United States

Harold I. Feldman,

• de Boer, Ian H., Division of Nephrology and Kidney Research Institute, University of Washington, Seattle, Washington, United States

Ian H. de Boer,

• Lash, James P., University of Illinois at Chicago, Chicago, Illinois, United States

James P. Lash,

• Chen, Jing, Tulane School of Medicine, New Orleans, Louisiana, United States

Jing Chen,

• Hsu, Chi-yuan, University of California San Francisco, San Francisco, California, United States

Chi-yuan Hsu,

• Dobre, Mirela A., Case Western Reserve University , Cleveland, Ohio, United States

Mirela A. Dobre,

• Lee, Jungwha, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Jungwha Lee,

• Rao, Panduranga S., University of Michigan Health System, Ann Arbor, Michigan, United States

Panduranga S. Rao,

• Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States

Alan S. Go,

• Townsend, Raymond R., University of Pennsylvania School of Medicine, Villanova, Pennsylvania, United States

Raymond R. Townsend,

• Wolf, Myles, Duke University, Durham, North Carolina, United States

Myles Wolf,

• Pasch, Andreas, University Hospital Bern, Bern, Switzerland

Andreas Pasch,

• Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Tamara Isakova,

Background

Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and predicts the risk of cardiovascular disease and mortality. We hypothesized that a novel measure of serum calcification propensity is associated with CAC among patients with CKD stages 2-4.

Methods

Among 780 participants from the CRIC Study, CAC was measured at baseline and a follow-up visit using electron beam or multidetector computed tomography. Calcification propensity was quantified at baseline as the transformation time (T50) from primary to secondary calciprotein particles, with lower T50 corresponding to higher calcification propensity. Poisson and linear regression were used to estimate associations between T50 and CAC, with a priori stratification by absence or presence of CAC at baseline.

Results

At baseline, 460 (59%) participants had any CAC and 255 (33%) participants had CAC score ≥100 Agatston units. Over an average 3-year follow-up, 65 (20%) participants without baseline CAC developed CAC while 89 participants (19%) with baseline CAC increased ≥100 Agatston units per year. After multivariable adjustment, lower T50 was associated with more severe CAC at baseline and over follow-up among those with baseline CAC (Table).

Conclusion

Among patients with CKD, higher serum calcification propensity is associated with more severe CAC and progression of CAC. Future studies should evaluate whether T50 predicts the risk of clinical cardiovascular disease and whether its determinants represent novel therapeutic targets.

Funding

• NIDDK Support