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Relationship between Kidney Function and Subclinical Atherosclerosis Progression Evaluated by Coronary Artery
Namuun Ganbaatar1, Aya Kadota1, Takashi Hisamatsu1,2
1NCD Epidemiology Research Center, Shiga University of Medical Science.
Journal of Atherosclerosis and Thrombosis
|October 25, 2021
Summary
Coronary artery calcification progression is linked to albuminuria and lower cystatin-based estimated glomerular filtration rate (eGFRcys). However, adjusting for risk factors weakened the association with eGFRcys, highlighting albuminuria as a key indicator.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Coronary artery calcification (CAC) progression is a significant indicator of cardiovascular disease risk.
- The influence of kidney function markers, including urinary albumin and estimated glomerular filtration rate (eGFR) calculated using cystatin (eGFRcys) and creatinine (eGFRcre), on CAC progression is not fully understood.
- Investigating these relationships is crucial for identifying individuals at higher risk for cardiovascular events.
Purpose of the Study:
- To examine the association between kidney function parameters (albuminuria, eGFRcys, eGFRcre) and the progression of coronary artery calcification (CAC) in a Japanese population.
- To determine if kidney function markers predict the annual increase in CAC scores over a follow-up period.
Main Methods:
- A population-based study involving 760 Japanese men aged 40-79 years.
- Kidney function assessed via eGFRcre, eGFRcys, and urine albumin-to-creatinine ratio (UACR).
- CAC progression defined by specific criteria based on baseline CAC scores (Agatston units).
- Robust Poisson regression used to analyze the relative risk (RR) of CAC progression.
Main Results:
- Over a mean follow-up of 4.9 years, 45.8% of participants showed CAC progression.
- Initial analysis revealed significant associations between CAC progression and albuminuria (RR: 1.29) and low eGFRcys (RR: 1.27).
- After adjusting for cardiovascular risk factors, albuminuria remained associated with CAC progression (RR: 1.20), while the association with low eGFRcys (RR: 1.19) was attenuated and no longer statistically significant. eGFRcre showed no significant association.
Conclusions:
- Albuminuria is independently associated with coronary artery calcification progression.
- The association between cystatin-based eGFR and CAC progression is influenced by other cardiovascular risk factors.
- These findings underscore the importance of monitoring kidney function, particularly albuminuria, in cardiovascular risk assessment.
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