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Progression of coronary calcification in pediatric chronic kidney disease stage 5

Mahmut Civilibal1, Salim Caliskan, Sebuh Kurugoglu

  • 1Department of Pediatric Nephrology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. drcivilibal@hotmail.com

Pediatric Nephrology (Berlin, Germany)
|November 5, 2008
PubMed

Insights

Coronary artery calcification (CAC) significantly progresses in children with chronic kidney disease (CKD) over two years. Higher calcium-phosphorus product correlated with increased CAC, while albumin levels showed an inverse relationship.

Area of Science:

  • Cardiology
  • Nephrology
  • Pediatrics

Background:

  • Coronary artery calcification (CAC) is prevalent in adults with chronic kidney disease (CKD).
  • Limited data exists on CAC progression in pediatric CKD populations.
  • Previous work identified CAC in 8 of 53 children with CKD.

Purpose of the Study:

  • To assess the natural history and progression of coronary artery calcification (CAC) in children with chronic kidney disease (CKD).
  • To identify factors associated with CAC progression in this cohort.

Main Methods:

  • Repeated CAC evaluation using multidetector spiral computed tomography (MDCT) after two years in 48 pediatric CKD patients.
  • Calculation of time-averaged mean values for cumulative exposure.
  • Analysis of the relationship between CAC score (CACS), calcium-phosphorus (CaxP) product, and serum albumin levels.

Main Results:

  • The median CAC score (CACS) increased substantially from 101.3 to 1759.2 Agatston units (AU) over two years.
  • Individual CAC scores showed varied changes, including decreases and increases.
  • No new calcification developed in patients who were initially free of CAC.
  • Final CACS positively correlated with the final calcium-phosphorus (CaxP) product.
  • CAC progression was inversely associated with the final serum albumin level.

Conclusions:

  • Coronary artery calcification (CAC) progresses significantly in children with chronic kidney disease (CKD).
  • The calcium-phosphorus product and serum albumin levels are associated with CAC progression in pediatric CKD.
  • This study provides crucial insights into the natural history of coronary calcification in the youngest cohort studied to date.

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