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Abstract: FR-PO262

Coronary Artery Calcification but Not Aortic Pulse Wave Velocity Predicts CKD Incidence and Early Progression

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Huntley, Geoffrey D., University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Gregg, L Parker, University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Kozlitina, Julia, University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Delemos, James, University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Hedayati, Susan, University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background

Both aortic arch pulse wave velocity (PWV), a marker of medial arterial stiffness, and coronary artery calcification (CAC), a marker of coronary atherosclerosis, have been shown to be associated with all-cause death, cardiovascular (CV) events, and end-stage renal disease. We investigated whether CAC and PWV predict earlier kidney events, such as incident albuminuria and loss of estimated glomerular filtration rate (eGFR), when interventions targeting these measures may improve long-term outcomes.

Methods

We conducted a prospective, community-based cohort study of Dallas Heart Study participants who underwent PWV and CAC measurement. eGFR was calculated using the 4-variable MDRD formula. The primary outcome of composite kidney events after 7 years of follow-up was incident chronic kidney disease (CKD) (albuminuria or eGFR <60 mL/min/1.73 m2) or a decrease in eGFR >2.5 mL/min/1.73 m2 per year. Secondary outcomes were CV events (myocardial infarction, stroke, coronary revascularization, and CV death) and death at a median follow-up of 13 years. Associations with composite kidney events and CV events and death were measured using logistic and Cox Proportional Hazards regression, respectively.

Results

A total of 2,062 participants had a mean age 45±9.3 years, 56% were female, 47% were African American, 10% had diabetes mellitus, and 7% had CKD at baseline. There were 187 kidney events, 177 CV events, and 165 deaths. Log transformed CAC taken continuously was associated with composite kidney events, aOR (95% CI), 1.16 (1.06, 1.27), CV events, aHR (95% CI) 1.38 (1.27, 1.51), and death, aHR (95% CI) 1.19 (1.10, 1.29) (Figure). CAC ≥100 Agatston units was associated with CV events, aHR (95% CI), 2.21 (1.49, 3.28) and death, aHR (95% CI) 2.30 (1.57, 3.37), but not kidney events. PWV taken continuously or in tertiles was not associated with kidney events, CV events, or death.

Conclusion

CAC, but not PWV, was independently associated with CKD incidence and progression, CV events, and death. These results suggest that CAC may be a useful tool to predict clinically meaningful early kidney outcomes in addition to CV events and death.