Related Experiment Video
Updated: May 17, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Relation between mild to moderate chronic kidney disease and coronary artery disease determined with coronary CT
Ivo A Joosen1, Frank Schiphof, Mathijs O Versteylen
1Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands. ivo.joosen@mumc.nl
Insights
Mild to moderate chronic kidney disease (CKD) is linked to more coronary plaque, but this association disappears when accounting for traditional cardiovascular risk factors. Further research is needed to understand the independent impact of CKD on heart disease.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Chronic kidney disease (CKD) stages are linked to higher cardiovascular event risk.
- Association between reduced kidney function and coronary artery calcification is known, but independence from traditional risk factors is unclear.
Purpose of the Study:
- To determine if mild to moderate CKD is independently associated with coronary plaque burden.
- To assess coronary plaque characteristics beyond traditional cardiovascular risk factors.
Main Methods:
- 2,038 patients with suspected coronary artery disease underwent coronary CT-angiography.
- Assessed traditional risk factors, coronary calcium score, and plaque characteristics.
- Patients grouped by estimated glomerular filtration rate (eGFR): normal (≥90), mild CKD (60-89), moderate CKD (30-59).
Main Results:
- Coronary calcium score increased with decreasing renal function (P<0.001).
- Higher plaque prevalence in mild (OR 1.83) and moderate CKD (OR 2.46) vs. normal function (P<0.001).
- Significant association between renal function and plaque presence/severity disappeared after adjusting for traditional risk factors.
Conclusions:
- Decreasing renal function correlates with increased coronary artery disease extent and severity.
- Mild to moderate CKD is not independently associated with coronary plaque burden after adjusting for traditional cardiovascular risk factors.
Background:
Both end-stage and milder stages of chronic kidney disease (CKD) are associated with an increased risk of adverse cardiovascular events. Several studies found an association between decreasing renal function and increasing coronary artery calcification, but it remains unclear if this association is independent from traditional cardiovascular risk factors. Therefore, the aim of this study was to investigate whether mild to moderate CKD is independently associated with coronary plaque burden beyond traditional cardiovascular risk factors.
Methods:
A total of 2,038 patients with symptoms of chest discomfort suspected for coronary artery disease underwent coronary CT-angiography. We assessed traditional risk factors, coronary calcium score and coronary plaque characteristics (morphology and degree of luminal stenosis). Patients were subdivided in three groups, based on their estimated glomerular filtration rate (eGFR) Normal renal function (eGFR ≥90 mL/min/1.73 m(2)); mild CKD (eGFR 60-89 mL/min/1.73 m(2)); and moderate CKD (eGFR 30-59 mL/min/1.73 m(2)).
Results:
Coronary calcium score increased significantly with decreasing renal function (P<0.001). Coronary plaque prevalence was higher in patients with mild CKD (OR 1.83, 95%CI 1.52-2.21) and moderate CKD (OR 2.46, 95%CI 1.69-3.59), compared to patients with normal renal function (both P<0.001). Coronary plaques with >70% luminal stenosis were found significantly more often in patients with mild CKD (OR 1.67 (95%CI 1.16-2.40) and moderate CKD (OR2.36, 95%CI 1.35-4.13), compared to patients with normal renal function (both P<0.01). After adjustment for traditional cardiovascular risk factors, the association between renal function and the presence of any coronary plaque as well as the association between renal function and the presence of coronary plaques with >70% luminal stenosis becomes weaker and were no longer statistically significant.
Conclusion:
Although decreasing renal function is associated with increasing extent and severity of coronary artery disease, mild to moderately CKD is not independently associated with coronary plaque burden after adjustment for traditional cardiovascular risk factors.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:28Imaging Studies for Cardiovascular System V: CT
01:30Coronary Artery Disease I: Introduction
01:25Chronic Kidney Disease I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Chronic Kidney Disease III: Interprofessional Care