ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO285

Deoxycholic Acid (DCA) and Coronary Artery Calcification (CAC) in the Chronic Renal Insufficiency Cohort (CRIC)

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Jovanovich, Anna Jeanette, Denver VA / University of Colorado, Denver, Colorado, United States
  • Cai, Xuan, Northwestern University, Chicago, Illinois, United States
  • Frazier, Rebecca, Northwestern, Chicago, Illinois, United States
  • Bundy, Joshua David, Northwestern University Feinberg School of Medicine, Evanston, Illinois, United States
  • He, Jiang, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States
  • Rao, Panduranga S., University of Michigan Health System, Ann Arbor, Michigan, United States
  • Lora, Claudia M., University of Illinois at Chicago, Chicago, Illinois, United States
  • Dobre, Mirela A., Case Western Reserve University, Cleveland, Ohio, United States
  • Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States
  • Shafi, Tariq, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Rhee, Eugene P., Massachusetts General Hospital, Newton, Massachusetts, United States
  • Chonchol, Michel, University of Colorado, Aurora, Colorado, United States
  • Miyazaki, Makoto, University of Colorado-Denver, Aurora, Colorado, United States
  • Isakova, Tamara, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
Background

Circulating levels of the secondary bile acid, DCA, are elevated in chronic kidney disease (CKD). In a small cohort of individuals with CKD 3b-4, higher plasma DCA was associated with prevalent CAC. Whether circulating DCA levels are associated with CAC prevalence, incidence, and progression in a large diverse CKD population is unknown.

Methods

We cross-sectionally and longitudinally evaluated the association between fasting serum DCA levels and CAC among 1057 CRIC participants using multivariable-adjusted regression models. CAC was measured in Agatston units at baseline and follow-up.

Results

Mean age was 57±12 years, 47% were female, and 41% were black. At baseline 676 (64%) had any CAC (CAC score >0 Agatston units), 405 (38%) had CAC >100, and 236 (22%) had CAC >400. In cross-sectional analyses, multivariable models adjusted for demographics and clinical factors including statin use showed no significant association between circulating DCA levels and CAC >0 compared to no CAC (CAC=0) (prevalence ratio per 1-SD increase in log DCA: 1.09, 95% CI 0.92-1.28). Similar results were observed when baseline CAC thresholds of >100, >200, >300, and >400 vs. no CAC (CAC=0) were used. 672 participants had follow-up CAC measurements. Over a mean follow-up of 3.2±0.6 years, of the 277 (41%) participants with no baseline CAC (CAC=0), 60 (22%) developed incident CAC (CAC >0). In the fully adjusted model, DCA was not significantly associated with incident CAC (CAC >0) (incidence ratio per 1-SD increase in log DCA: 1.06, 95% CI 0.83-1.34). Of the 395 (59%) participants with any baseline CAC (CAC >0), 20% and 7% had an increase of >100 and >200 Agatston units/year, respectively, at follow-up. In the fully adjusted model, DCA was not associated with CAC progression (risk ratio for increase in >100 and >200 Agatston units/year per 1-SD increase in log DCA: 1.08, 95% 0.87-1.34 and 1.18, 95% CI 0.77-1.82, respectively).

Conclusion

In CRIC participants, DCA was not associated with prevalent, incident, or progression of CAC.

Funding

  • NIDDK Support