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Kidney function and progression of coronary artery calcium in community-dwelling older adults (from the Rancho

Simerjot Kaur Jassal1, Michel Chonchol, Gail A Laughlin

  • 1Division of General Internal Medicine, Department of Medicine, University of California-San Diego, La Jolla, CA, USA. sjassal@ucsd.edu

The American Journal of Cardiology
|August 14, 2012
PubMed

Insights

Kidney function (eGFR) and albuminuria (ACR) do not predict coronary artery calcium (CAC) progression in older adults. These markers are not recommended for screening subclinical cardiovascular disease in asymptomatic elderly individuals.

Area of Science:

  • Nephrology
  • Cardiology
  • Geriatrics

Background:

  • Few longitudinal studies examine the link between kidney function (eGFR) and albuminuria (ACR) with coronary artery calcium (CAC).
  • Existing research on this association is contradictory, necessitating further investigation.

Purpose of the Study:

  • To investigate the longitudinal association between estimated glomerular filtration rate (eGFR) and albuminuria (ACR) with coronary artery calcium (CAC) severity and progression.
  • To determine if eGFR or ACR can identify asymptomatic older adults who would benefit from CAC screening for subclinical cardiovascular disease.

Main Methods:

  • 421 community-dwelling older adults without known heart disease were enrolled.
  • eGFR and ACR were assessed between 1997-1999.
  • Coronary artery calcium (CAC) was measured via electron-beam computed tomography in 2000-2001 and again 4.5 years later.
  • Logistic regression analyses were used to assess associations.

Main Results:

  • No significant association was found between eGFR or ACR and CAC severity at baseline.
  • Neither eGFR nor ACR predicted CAC progression over the follow-up period.
  • 46% of participants demonstrated CAC progression.

Conclusions:

  • The study does not support using eGFR or ACR to screen asymptomatic older adults for subclinical cardiovascular disease using CAC scans.
  • Kidney function and CAC may not progress concurrently in the elderly population.

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