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Serum Calcification Propensity and Clinical Events in CKD

Joshua D Bundy1,2, Xuan Cai2, Rupal C Mehta2,3

  • 1Department of Preventive Medicine.

Clinical Journal of the American Society of Nephrology : CJASN
|October 30, 2019
PubMed

Insights

Higher serum calcification propensity in patients with chronic kidney disease (CKD) is linked to increased risks of cardiovascular disease, end-stage kidney disease (ESKD), and mortality. However, this association is dependent on kidney function.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks for cardiovascular disease (CVD), end-stage kidney disease (ESKD), and mortality.
  • Vascular calcification is a significant pathway contributing to increased CVD risk in CKD patients.
  • A novel measure of serum calcification propensity was investigated for its association with adverse outcomes in CKD.

Purpose of the Study:

  • To investigate the association between serum calcification propensity, measured by transformation time (T50), and the risk of cardiovascular events, ESKD, and mortality in CKD stages 2-4.
  • To determine if T50 is an independent predictor of these adverse outcomes.

Main Methods:

  • Utilized data from 3404 participants in the Chronic Renal Insufficiency Cohort Study.
  • Quantified calcification propensity using T50, where lower T50 indicates higher propensity.
  • Employed multivariable-adjusted Cox proportional hazards regression to assess associations with adjudicated outcomes over a median follow-up of 7.1 years.

Main Results:

  • Lower T50 was significantly associated with increased risk of atherosclerotic cardiovascular disease (HR 1.14), ESKD within 3 years (HR 1.68), and all-cause mortality (HR 1.16) after adjusting for traditional risk factors.
  • No significant association was found between lower T50 and heart failure risk.
  • After further adjustment for estimated glomerular filtration rate (eGFR) and 24-hour urinary protein, the associations of T50 with atherosclerotic cardiovascular disease, ESKD, and mortality were no longer significant.

Conclusions:

  • In patients with CKD stages 2-4, higher serum calcification propensity is associated with increased risks of atherosclerotic cardiovascular disease, ESKD, and all-cause mortality.
  • This association is not independent of kidney function, suggesting that kidney function status plays a crucial role in mediating the relationship.
Abstract

Keywords:
atherosclerosiscardiovascular diseasechronic kidney diseasechronic kidney failurechronic renal insufficiencyclinical epidemiologyconfidence intervalsend-stage renal diseasefollow-up studiesglomerular filtration rateheart failurehumansmortalitymyocardial infarctionperipheral arterial diseaseprospective studiesrisk factorsstrokevascular calcification

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