Coronary artery calcium and risk of chronic kidney disease in young and middle-aged adults
Coronary artery calcium and risk of chronic kidney disease in young and middle-aged adults
Background. The role of the coronary artery calcium score (CACS) in incident chronic kidney disease (CKD) in asymptomatic young populations remains unclear. The aim of this study was to evaluate the association between CACSs and CKD development in adults. Methods. A cohort study of 113 171 Korean adults (mean age 40.6 years) without CKD and proteinuria at baseline who underwent a cardiac tomography estimation of CACSs during health screening examinations was performed (median followup 4.2 years). The outcome was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m
2 and/or the presence of proteinuria. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD were estimated using Cox proportional hazards regression analyses. Results. A higher CACS was moderately associated with an increased risk of CKD in a dose-dependent manner. The multivariable-adjusted HRs for CKD comparing CACSs 1–100, 101–300 and >300 with a CACS of 0 were 1.15 (95% CI 1.05–1.25), 1.37 (95% CI 1.13–1.66) and 1.71 (95% CI 1.32–2.22), respectively (P for trend <.001). When CKD was defined using low eGFR and proteinuria separately, corresponding HRs for low eGFR were 1.31 (95% CI 1.05–1.62), 1.41 (95% CI 0.95–2.11) and 1.86 (95% CI 1.16–3.00), respectively (P for trend = .001), while the HRs for proteinuria were 1.11 (95% CI 1.02–1.21), 1.32 (95% CI 1.07–1.64) and 1.57 (95% CI 1.16–2.12), respectively. Conclusions. A higher CACS was progressively associated with an increased risk of CKD, even at low CACSs. Individuals with a CACS >0 appear to have an increased risk of CKD and may benefit from preventive measures to reduce CKD risk.
albuminuria, chronic kidney disease, cohort study, coronary artery calcium score, subclinical atherosclerosis
1439-1447
Kim, Yejin
a549eda4-e4dd-48d0-aaca-3cdef9378904
Kang, Jeonggyu
8d4ffc05-3ed1-4d31-99e9-efc2fbc06a11
Chang, Yoosoo
dc86790f-6692-4655-b151-fc44394cc671
Hyun, Young Youl
b832d7ba-c448-4cba-8b0c-12e6cb6ddf66
Lee, Kyu-Beck
43173fc1-9f5c-4929-985d-0db4b6addd11
Shin, Hocheol
48eca624-96bd-4fc1-805b-53ac990f94b4
Wild, Sarah H.
d6db7bdb-1794-4b80-acdd-c119fabeab39
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
5882b943-982f-44a4-9e3f-c10fd9ad4640
15 September 2022
Kim, Yejin
a549eda4-e4dd-48d0-aaca-3cdef9378904
Kang, Jeonggyu
8d4ffc05-3ed1-4d31-99e9-efc2fbc06a11
Chang, Yoosoo
dc86790f-6692-4655-b151-fc44394cc671
Hyun, Young Youl
b832d7ba-c448-4cba-8b0c-12e6cb6ddf66
Lee, Kyu-Beck
43173fc1-9f5c-4929-985d-0db4b6addd11
Shin, Hocheol
48eca624-96bd-4fc1-805b-53ac990f94b4
Wild, Sarah H.
d6db7bdb-1794-4b80-acdd-c119fabeab39
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
5882b943-982f-44a4-9e3f-c10fd9ad4640
Kim, Yejin, Kang, Jeonggyu, Chang, Yoosoo, Hyun, Young Youl, Lee, Kyu-Beck, Shin, Hocheol, Wild, Sarah H., Byrne, Christopher and Ryu, Seungho
(2022)
Coronary artery calcium and risk of chronic kidney disease in young and middle-aged adults.
Nephrology Dialysis Transplantation, 38 (6), .
(doi:10.1093/ndt/gfac272).
Abstract
Background. The role of the coronary artery calcium score (CACS) in incident chronic kidney disease (CKD) in asymptomatic young populations remains unclear. The aim of this study was to evaluate the association between CACSs and CKD development in adults. Methods. A cohort study of 113 171 Korean adults (mean age 40.6 years) without CKD and proteinuria at baseline who underwent a cardiac tomography estimation of CACSs during health screening examinations was performed (median followup 4.2 years). The outcome was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m
2 and/or the presence of proteinuria. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD were estimated using Cox proportional hazards regression analyses. Results. A higher CACS was moderately associated with an increased risk of CKD in a dose-dependent manner. The multivariable-adjusted HRs for CKD comparing CACSs 1–100, 101–300 and >300 with a CACS of 0 were 1.15 (95% CI 1.05–1.25), 1.37 (95% CI 1.13–1.66) and 1.71 (95% CI 1.32–2.22), respectively (P for trend <.001). When CKD was defined using low eGFR and proteinuria separately, corresponding HRs for low eGFR were 1.31 (95% CI 1.05–1.62), 1.41 (95% CI 0.95–2.11) and 1.86 (95% CI 1.16–3.00), respectively (P for trend = .001), while the HRs for proteinuria were 1.11 (95% CI 1.02–1.21), 1.32 (95% CI 1.07–1.64) and 1.57 (95% CI 1.16–2.12), respectively. Conclusions. A higher CACS was progressively associated with an increased risk of CKD, even at low CACSs. Individuals with a CACS >0 appear to have an increased risk of CKD and may benefit from preventive measures to reduce CKD risk.
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NDT-00464-2022R2_Manuscript_clean
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NDT-00464-2022R2_Supplemental_materials
- Accepted Manuscript
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Figure 1 CAC_CKD
- Accepted Manuscript
More information
Accepted/In Press date: 8 September 2022
e-pub ahead of print date: 15 September 2022
Published date: 15 September 2022
Additional Information:
Funding Information:
This article was supported by the Excellence in Research Award Research Fund, Sungkyunkwan University, 2020.
Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. All rights reserved.
Keywords:
albuminuria, chronic kidney disease, cohort study, coronary artery calcium score, subclinical atherosclerosis
Identifiers
Local EPrints ID: 470379
URI: http://eprints.soton.ac.uk/id/eprint/470379
ISSN: 0931-0509
PURE UUID: 9a613900-b3e2-4d85-9d6f-c4bff42f2300
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Date deposited: 07 Oct 2022 16:36
Last modified: 17 Mar 2024 07:30
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Contributors
Author:
Yejin Kim
Author:
Jeonggyu Kang
Author:
Yoosoo Chang
Author:
Young Youl Hyun
Author:
Kyu-Beck Lee
Author:
Hocheol Shin
Author:
Sarah H. Wild
Author:
Seungho Ryu
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