Kidney Function and Arterial Calcification in Major Vascular Beds
2019
textabstractBackground-—The purpose of this study was to investigate the association between kidney function and arterial calcification in
major vascular beds and to establish whether arterial calcification mediates the relation between kidney function measures and
cardiovascular disease (CVD) incidence.
Methods and Results-—In 2241 participants from the Rotterdam Study (mean age 69 years, 52% female), kidney function was
assessed using the estimated glomerular filtration rate and urine albumin-to-creatinine ratio. All participants underwent
noncontrast computed tomography to quantify the amount of arterial calcification in the coronary arteries, aortic arch, extracranial,
and intracranial internal carotid arteries. We used linear regression models, adjusted for age, sex, and cardiovascular risk factors,
to evaluate the association between kidney function and arterial calcification volume in the 4 vessel beds. Incidence rate of CVD
was calculated in 3 groups of participants based on their kidney function and presence of arterial calcification. We conducted
mediation analysis to evaluate whether arterial calcification mediates this association. We found that in age- and sex-adjusted
models, lower estimated glomerular filtration rate and higher albumin-to-creatinine ratio were associated with larger calcification
volumes in all 4 vascular beds. Adjusting for cardiovascular risk factors attenuated the effect estimates. CVD incidence was higher
in participants with estimated glomerular filtration rate <60 mL/min per 1.73 m2 and presence of arterial calcification compared
with individuals with estimated glomerular filtration rate >60 and no calcification. After adjusting for cardiovascular risk factors,
arterial calcification did not mediate the association between kidney function measures and CVD incidence.
Conclusions-—The association of impaired kidney function and larger volumes of arterial calcification is partly explained by
cardiovascular risk factors. Arterial calcification does not mediate the association between kidney function and CVD beyond
cardiovascular risk factors.
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