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Determinants of coronary artery calcification in diabetics with and without nephropathy

Rajnish Mehrotra1, Matthew Budoff, Peter Christenson

  • 1Division of Nephrology and Hypertension, Harbor-UCLA Medical Center, Torrance, California 90502, USA. rmehrotra@labiomed.org

Kidney International
|October 22, 2004
PubMed

Insights

Coronary artery calcification in diabetic kidney disease is linked to hypertension, not mineral metabolism issues. This suggests hypertension management may reduce calcification in early diabetic kidney disease.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Coronary artery calcification (CAC) in diabetes mellitus correlates with atherosclerosis.
  • Disordered mineral metabolism contributes to vascular calcification in end-stage renal disease (ESRD).

Purpose of the Study:

  • To determine the roles of accelerated atherosclerosis and disordered mineral metabolism in CAC among patients with chronic kidney disease (CKD).

Main Methods:

  • A pilot study of 90 patients with type 2 diabetes mellitus (30 normoalbuminuria, 60 with diabetic nephropathy [DN]).
  • Evaluated CAC prevalence and severity, and four measures of mineral metabolism.
  • Assessed the impact of hypertension severity.

Main Results:

  • CAC was significantly more prevalent and severe in patients with DN compared to diabetic controls.
  • No correlation was found between mineral metabolism markers and CAC.
  • Hypertension severity, indicated by antihypertensive medication use, explained the differences in CAC burden.

Conclusions:

  • In predialysis patients with DN, high CAC burden is likely independent of disordered mineral metabolism, unlike in ESRD.
  • Hypertension severity is a probable intervention target for reducing CAC in early diabetic CKD.
Abstract

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