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Coronary calcification is associated with lower bone formation rate in CKD patients not yet in dialysis treatment

Cristianne Tomiyama1, Aluizio B Carvalho, Andrea Higa

  • 1Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|July 15, 2009
PubMed

Insights

Low bone formation is linked to coronary artery calcification (CAC) in chronic kidney disease (CKD) patients before dialysis. This finding identifies a new cardiovascular risk factor in early-stage kidney disease.

Area of Science:

  • Nephrology
  • Cardiology
  • Bone Metabolism

Background:

  • Vascular calcification is a significant predictor of mortality in hemodialysis patients and is linked to bone metabolism issues.
  • Vascular calcification is also observed in earlier stages of chronic kidney disease (CKD).

Purpose of the Study:

  • To investigate the association between coronary artery calcification (CAC) and bone histomorphometric parameters in predialysis CKD patients.

Main Methods:

  • Coronary artery calcification (CAC) was assessed using multislice coronary tomography.
  • Bone histomorphometry was evaluated through undecalcified bone biopsy.
  • Statistical analysis included multiple logistic regression, adjusted for age, sex, and diabetes.

Main Results:

  • Coronary artery calcification (CAC) was detected in 66% of patients, with a median calcium score of 89.7 AU.
  • Common bone alterations included low trabecular bone volume, increased eroded and osteoclast surfaces, and a low bone-formation rate (BFR/BS).
  • A low bone-formation rate (BFR/BS) was independently associated with the presence of coronary calcification (p = .009; OR = 0.15).

Conclusions:

  • A high prevalence of CAC exists in asymptomatic predialysis CKD patients.
  • Low bone formation is independently associated with CAC in this population.
  • Low bone-formation rate is a potential nontraditional risk factor for cardiovascular disease in CKD patients.

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