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Comparative Study
. 2012 Nov 15;110(10):1425-33.
doi: 10.1016/j.amjcard.2012.06.053. Epub 2012 Aug 8.

Kidney function and progression of coronary artery calcium in community-dwelling older adults (from the Rancho Bernardo Study)

Simerjot Kaur Jassal  1 , Michel Chonchol, Gail A Laughlin, Kevin M Cummins, Gerard Smits, Caroline K Kramer, Joachim H Ix, Elizabeth Barrett-Connor
Affiliations
Comparative Study

Kidney function and progression of coronary artery calcium in community-dwelling older adults (from the Rancho Bernardo Study)

Simerjot Kaur Jassal et al. Am J Cardiol. .

Abstract

Longitudinal studies of the association of estimated glomerular filtration rate (eGFR) and albuminuria with coronary artery calcium (CAC), a measure of cardiovascular disease burden, are few and contradictory. In this study, 421 community-dwelling men and women (mean age 67 years) without known heart disease had eGFRs assessed using the Modification of Diet in Renal Disease (MDRD) equation and albuminuria assessed by urine albumin/creatinine ratio (ACR) from 1997 to 1999. The mean eGFR was 78 ml/min/1.73 m(2), and the median ACR was 10 mg/g. CAC was measured using electron-beam computed tomography from 2000 to 2001, when the median total Agatston CAC score was 77; 4.5 years later, 338 participants still without heart disease underwent repeat scans (median CAC score 112); 46% of participants showed CAC progression, defined as an increase ≥2.5 mm(3) in square root-transformed CAC volume score. Cross-sectional and longitudinal logistic regression analyses showed no separate or joint association between eGFR or ACR and CAC severity or progression. In conclusion, this study does not support the use of eGFR or ACR to identify asymptomatic older adults who should be screened for subclinical cardiovascular disease with initial or sequential scanning for CAC. In the elderly, kidney function and CAC may not progress together.

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Figures

FIGURE 1
FIGURE 1
Study flow diagram
FIGURE 2
FIGURE 2
FIGURE 2A. Odds ratio estimates for the association of eGFR and ACR and CVD risk factors with increasing CAC severity at baseline. Each factor is adjusted for age and sex. Odds ratios for continuous variables are presented for 1-SD intervals, except aage, which is presented for 10-year intervals and asex, which is for men. The values shown in the middle of the bar are the OR estimates; the bars represent the 95% CIs FIGURE 2B. Odds ratio estimates for the association of eGFR and ACR and CVD risk factors with CAC progression. Each factor is adjusted for age, sex and time interval. Odds ratios for continuous variables are presented for 1-SD intervals, except aage, which is presented for 10-year intervals and asex, which is for men. The values shown in the middle of the bar are the OR estimates; the bars represent the 95% CI
FIGURE 2
FIGURE 2
FIGURE 2A. Odds ratio estimates for the association of eGFR and ACR and CVD risk factors with increasing CAC severity at baseline. Each factor is adjusted for age and sex. Odds ratios for continuous variables are presented for 1-SD intervals, except aage, which is presented for 10-year intervals and asex, which is for men. The values shown in the middle of the bar are the OR estimates; the bars represent the 95% CIs FIGURE 2B. Odds ratio estimates for the association of eGFR and ACR and CVD risk factors with CAC progression. Each factor is adjusted for age, sex and time interval. Odds ratios for continuous variables are presented for 1-SD intervals, except aage, which is presented for 10-year intervals and asex, which is for men. The values shown in the middle of the bar are the OR estimates; the bars represent the 95% CI
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References

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