BACKGROUND: Presence of systemic inflammation in chronic kidney disease (CKD) is associated with advanced coronary artery calcification (CAC). The prognostic significance of this association, however, is unknown. We evaluated the associations between CAC, estimated glomerular filtration rate (eGFR) and all-cause mortality, to determine whether the associations differ according to the presence of systemic inflammation. METHODS AND RESULTS: We followed 30,703 consecutive individuals who underwent CAC measurement for a median of 79 months (IQR, 65-96 months). Patients were categorized according to baseline CAC score (0, 1-99, 100-399 and ≥400), eGFR (<45, 45-59, 60-74, 75-89, 90-104, and ≥105 ml/min/1.73 m(2)) and high-sensitivity C-reactive protein (hsCRP; <2.0, and ≥2.0 mg/L). Prevalence and extent of CAC were greater in those with lower eGFR and higher hsCRP accordingly, even after adjustment. Lower eGFR was strongly associated with higher CAC score (≥400), and the association was more significant in patients with higher hsCRP. The greater CAC burden was associated with worse outcome in the CKD patients (eGFR <60 ml/min/1.73 m(2)) only in those with higher hsCRP. CONCLUSIONS: Patients with low eGFR and more extensive CAC had greater risk of mortality, and associations differed according to the presence of systemic inflammation. Among the CKD patients, coronary evaluation may be considered for those with elevated hsCRP. (Circ J 2016; 80: 1644-1652).
BACKGROUND: Presence of systemic inflammation in chronic kidney disease (CKD) is associated with advanced coronary artery calcification (CAC). The prognostic significance of this association, however, is unknown. We evaluated the associations between CAC, estimated glomerular filtration rate (eGFR) and all-cause mortality, to determine whether the associations differ according to the presence of systemic inflammation. METHODS AND RESULTS: We followed 30,703 consecutive individuals who underwent CAC measurement for a median of 79 months (IQR, 65-96 months). Patients were categorized according to baseline CAC score (0, 1-99, 100-399 and ≥400), eGFR (<45, 45-59, 60-74, 75-89, 90-104, and ≥105 ml/min/1.73 m(2)) and high-sensitivity C-reactive protein (hsCRP; <2.0, and ≥2.0 mg/L). Prevalence and extent of CAC were greater in those with lower eGFR and higher hsCRP accordingly, even after adjustment. Lower eGFR was strongly associated with higher CAC score (≥400), and the association was more significant in patients with higher hsCRP. The greater CAC burden was associated with worse outcome in the CKDpatients (eGFR <60 ml/min/1.73 m(2)) only in those with higher hsCRP. CONCLUSIONS:Patients with low eGFR and more extensive CAC had greater risk of mortality, and associations differed according to the presence of systemic inflammation. Among the CKDpatients, coronary evaluation may be considered for those with elevated hsCRP. (Circ J 2016; 80: 1644-1652).
Authors: Prathibha R Gajjala; Heike Bruck; Heidi Noels; Georg Heinze; Francesco Ceccarelli; Andreas Kribben; Julio Saez-Rodriguez; Nikolaus Marx; Walter Zidek; Joachim Jankowski; Vera Jankowski Journal: J Mol Med (Berl) Date: 2019-08-05 Impact factor: 4.599
Authors: Ida Maria Hjelm Sørensen; Sasha Asbøll Kepler Saurbrey; Henrik Øder Hjortkjær; Philip Brainin; Nicholas Carlson; Ellen Linnea Freese Ballegaard; Anne-Lise Kamper; Christina Christoffersen; Bo Feldt-Rasmussen; Klaus Fuglsang Kofoed; Susanne Bro Journal: BMC Nephrol Date: 2020-12-09 Impact factor: 2.388