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Updated: Aug 20, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Coronary artery calcification in patients with CRF not undergoing dialysis
Domenico Russo1, Giuseppe Palmiero, Antonietta P De Blasio
1Department of Nephrology, University Federico II, Naples, Italy. gigi.russo@libero.it
Insights
Coronary artery calcification (CAC) is common in chronic renal failure (CRF) patients before dialysis. Age is the only predictor, not serum levels of calcium, phosphorus, or iPTH.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Coronary artery calcification (CAC) indicates atherosclerosis and cardiovascular risk.
- CAC is more prevalent in uremic patients, with most data from dialysis patients.
- This study investigates CAC in chronic renal failure (CRF) patients not yet on dialysis.
Purpose of the Study:
- To determine the prevalence and extent of CAC in non-dialysis CRF patients.
- To compare CAC in CRF patients with controls.
- To identify predictors of CAC in early-stage CRF.
Main Methods:
- Compared 85 non-dialysis CRF outpatients with 55 controls (healthy and hypertensive).
- Excluded patients with diabetes, prior heart attack, or revascularization.
- Assessed CAC using spiral computed tomography (CT) and evaluated clinical/biochemical data, including calcium, phosphorus, iPTH, homocysteinemia, and C-reactive protein.
Main Results:
- CAC was present in 40% of CRF patients versus 13% of controls.
- Age was the sole significant predictor of CAC (P < 0.001).
- In a subset, CAC scores increased over a mean of 7.9 months, indicating progression.
Conclusions:
- CAC is prevalent in early-stage CRF, higher than in controls but lower than in dialysis patients.
- Serum calcium, phosphorus, iPTH, and inflammation markers do not predict CAC presence or progression.
- Age is a key factor in CAC development in pre-dialysis CRF.
Background:
Coronary artery calcification (CAC) correlates with the extent of coronary atherosclerosis and, consequently, with an increased risk for cardiovascular events. CAC is more frequent in uremic patients than in the general population. Nearly all data about CAC relate to patients on dialysis therapy. This study evaluates the prevalence and extent of CAC in patients with chronic renal failure (CRF) not yet on dialysis therapy.
Methods:
Consecutive outpatients with CRF not on dialysis therapy were enrolled and compared with controls (ie, healthy volunteers and patients with essential hypertension with normal renal function). Patients and controls were asymptomatic and had no previous history of myocardial infarction, coronary bypass surgery, or angioplasty. Patients with diabetes were excluded. Clinical characteristics, biochemical test results (included homocysteinemia and C-reactive protein level), and serum concentrations of calcium, phosphorus, and intact parathyroid hormone (iPTH) were evaluated in patients and controls. CACs were searched for and scored by means of spiral computed tomography (CT). To assess the CAC progression rate, spiral CT was repeated in some patients.
Results:
Eighty-five patients and 55 controls were studied. Patients were aged 52 +/- 13 years and had a CRF duration of 6.3 +/- 5.6 years, glomerular filtration rate of 33.0 +/- 16.0 mL/min (0.55 +/- 0.27 mL/s), serum calcium level of 9.5 +/- 0.5 mg/dL (2.37 +/- 0.12 mmol/L), serum phosphorus level of 4.1 +/- 0.9 mg/dL (1.32 +/- 0.29 mmol/L), and serum iPTH level of 143 +/- 121 pg/mL (ng/L). CAC was found in 40% of patients and 13% of controls; calcification scores were 422 +/- 634 in patients and 43.9 +/- 33 in controls. Only age ( P < 0.001) was a predictor of CAC. In patients with a repeated score performed (after a mean of 7.9 months), calcification scores increased (from 383 +/- 627 to 682 +/- 890) in 8 of 10 patients.
Conclusion:
CAC is already present in the early phase of CRF; the prevalence is greater in patients with CRF than in controls, but less than that reported in dialysis patients. Serum concentrations of calcium, phosphorus, iPTH, and inflammation markers do not predict the appearance or progression of CAC.
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