Quantitative Analysis of Abdominal Aortic Calcification in CKD Patients Without Dialysis Therapy by Use of the Agatston Score

Background/Aim: The aim of the present study was to quantitatively examine factors associated with aortic calcification in non-dialysis CKD patients. Methods: We quantitatively investigated aortic calcification from the renal artery to the bifurcation in 149 non-dialysis CKD patients (58 +/- 16 years; 96 males and 53 females, 48 diabetics; eGFR 40.3 +/- 29.3 ml/min), and measured Agatston scores using multi-slice computed tomography. Result: Of 149 patients, aortic calcification was present in 117. In patients with aortic calcification, age (p < 0.001), C-reactive protein (p < 0.001), and intact-PTH (p < 0.001) were significantly higher, estimated glomerular filtration rate (eGFR) was significantly lower (p < 0.001), and diabetes was observed more often (p < 0.05). In regards to the degree of aortic calcification, the Agatston scores correlated significantly and positively with age (rho = 0.438, p < 0.001) and serum phosphate (rho = 0.208, p = 0.024), and correlated significantly but negatively with e-GFR (rho = -0.353, p < 0.001). In multiple regression analysis, eGFR was associated significantly and independently with the log [Agatston score] (beta = -0.346, p < 0.01), after adjustment for several confounders including serum phosphate and the presence of diabetes. Conclusions: Hyperphospatemia, chronic inflammation, diabetes, and decreased GFR are associated significantly with the presence of aortic calcification in non-dialysis CKD patients. Decreased eGFR was associated significantly and independently with the quantitative degree of aortic calcification. Copyright (C) 2014 S. Karger AG, Basel