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Abdominal aortic calcification and renal resistive index in patients with chronic kidney disease: is there a
Gabriel Stefan1, Cristina Capusa, Simona Stancu
1"Dr. Carol Davila" Teaching Hospital of Nephrology, Bucharest, Romania.
Insights
Abdominal aortic calcification (AAC) correlates with renal resistive index (RRI) in chronic kidney disease (CKD) patients. The Kauppila score for AAC may estimate RRI, indicating intrarenal vascular status.
Area of Science:
- Nephrology
- Cardiology
- Vascular Biology
Background:
- Chronic kidney disease (CKD) patients exhibit increased cardiovascular risk.
- Abdominal aortic calcification (AAC) and renal resistive index (RRI) are markers of cardiovascular outcome.
Purpose of the Study:
- To evaluate the relationship between AAC and RRI in non-dialysis CKD patients.
- To assess the utility of the Kauppila score for AAC in estimating RRI.
Main Methods:
- Prospective enrollment of 77 stable CKD patients (stages 3B-4).
- Assessment of AAC (Kauppila score), RRI, carotid intima-media thickness (IMT), cardio-ankle vascular index (CAVI), and ankle-brachial index (ABI).
- Evaluation of traditional and non-traditional atherosclerosis risk factors.
Main Results:
- High prevalence of AAC (77%) in the cohort.
- Direct correlation found between AAC score and RRI (rs = 0.35, p < 0.001).
- AAC score negatively correlated with ABI (rs = -0.51) and positively with IMT (rs = 0.27).
Conclusions:
- The Kauppila score for AAC correlates with RRI in non-dialysis CKD patients.
- AAC score may serve as a convenient tool for estimating RRI and intrarenal vascular status.
- Further research is needed to confirm these findings.
Background:
We aimed to evaluate the relationship between abdominal aortic calcification (AAC) and renal resistive index (RRI), parameters associated with cardiovascular outcome, in non-dialysis chronic kidney disease (CKD) patients.
Methods:
Seventy-seven stable patients mainly in CKD stages 3B and 4 (44 and 28%), median age 69 years, with a positive history of systemic atherosclerosis were prospectively enrolled. RRI, carotid intima-media thickness (IMT), Kauppila score for AAC (AACs), cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) were assessed. Traditional and non-traditional atherosclerosis risk factors were also evaluated.
Results:
Vascular (50%), diabetic (26%) and primary glomerular nephropathies (8 %) were the main causes of CKD. AAC was highly prevalent (77%). In the whole cohort, RRI was directly related to AACs (rs = 0.35, p < 0.001). AACs correctly identified patients with RRI >0.7 in 69% (56-81%) of cases, a cut-off of 5 resulting the best combination of sensitivity (65%) and specificity (68%). Compared to those with AACs <5, patients with AACs >5 were older, had higher serum cholesterol, C-reactive protein and IMT, lower ABI, but similar CAVI, estimated glomerular filtration rate, serum calcium and phosphate. In the whole cohort, AACs was negatively correlated with ABI (rs = -0.51, p < 0.001) and positively with IMT (rs = 0.27, p = 0.01), supporting a role for Kauppila score in integrating information on both intra- and extrarenal atherosclerosis.
Conclusions:
As Kauppila score correlates with RRI in non-dialysis CKD patients, it could be a fast, convenient and relatively inexpensive tool for estimating RRI, and consequently the intrarenal vascular status, but further research is warranted.
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