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. 2011 Jun;6(6):1456-62.
doi: 10.2215/CJN.10061110. Epub 2011 May 26.

Is coronary artery calcification associated with vertebral bone density in nondialyzed chronic kidney disease patients?

Agostinho Filgueira  1 , Aluizio Barbosa Carvalho, Cristiane Tomiyama, Andrea Higa, Carlos E Rochitte, Raul D Santos, Maria Eugênia F Canziani
Affiliations

Is coronary artery calcification associated with vertebral bone density in nondialyzed chronic kidney disease patients?

Agostinho Filgueira et al. Clin J Am Soc Nephrol. 2011 Jun.

Abstract

Background and objectives: Low bone mineral density and coronary artery calcification (CAC) are highly prevalent among chronic kidney disease (CKD) patients, and both conditions are strongly associated with higher mortality. The study presented here aimed to investigate whether reduced vertebral bone density (VBD) was associated with the presence of CAC in the earlier stages of CKD.

Design, setting, participants, & measurements: Seventy-two nondialyzed CKD patients (age 52 ± 11.7 years, 70% male, 42% diabetics, creatinine clearance 40.4 ± 18.2 ml/min per 1.73 m(2)) were studied. VBD and CAC were quantified by computed tomography.

Results: CAC > 10 Agatston units (AU) was observed in 50% of the patients (median 120 AU [interquartile range 32 to 584 AU]), and a calcification score ≥ 400 AU was found in 19% (736 [527 to 1012] AU). VBD (190 ± 52 Hounsfield units) correlated inversely with age (r = -0.41, P < 0.001) and calcium score (r = -0.31, P = 0.01), and no correlation was found with gender, creatinine clearance, proteinuria, lipid profile, mineral parameters, body mass index, and diabetes. Patients in the lowest tertile of VBD had expressively increased calcium score in comparison to the middle and highest tertile groups. In the multiple logistic regression analysis adjusting for confounding variables, low VBD was independently associated with the presence of CAC.

Conclusions: Low VBD was associated with CAC in nondialyzed CKD patients. The authors suggest that low VBD might constitute another nontraditional risk factor for cardiovascular disease in CKD.

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Figures

Figure 1.
Figure 1.
Quantitative computed tomography (CT) images of the thoracic vertebral body. The white circle in panel B depicts the tissue attenuation data measured by the computer software in the region of interest (trabecular bone) chosen for analysis.
Figure 2.
Figure 2.
Correlation between vertebral bone density (VBD) and age. HU, Hounsfield unit.
Figure 3.
Figure 3.
Correlation between VBD and calcium score. AU, Agatston unit.
Figure 4.
Figure 4.
Proportion of patients with coronary artery calcification (CAC) according to the tertiles of VBD.
See this image and copyright information in PMC

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