Young Youl Hyun1, Hyang Kim1, Kook-Hwan Oh2, Curie Ahn2, Sue K Park3, Dong Wan Chae4, Yun Kyu Oh5, Kyu Hun Choi6, Seung Hyeok Han6, Yeong Hoon Kim7, Kyu-Beck Lee1. 1. Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea. 2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 4. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea. 5. Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 6. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 7. Department of Internal Medicine, Inje University, Pusan Paik Hospital, Busan, Republic of Korea.
Abstract
BACKGROUND: The independent association between eGFR and coronary artery calcification (CAC) is complex and not clear. The aim of this study is to investigate the relationship between eGFR calculated from different equations and CAC in predialysis CKD patients in Korea. METHODS: In this cross-sectional study, we analyzed 1,533 patients from the KNOW-CKD cohort. eGFR was calculated by a four-variable MDRD equation (eGFRMDRD ), CKD-EPI creatinine equations (eGFRC r ), CKD-EPI Cystatin C equation (eGFRC ys ), and CKD-EPI Creatinine-Cystatin equation (eGFRC rC ys ). Participants were divided into eGFR categories (< 30, 30-59, 60-89, ≥ 90 ml/min/1.73 m2 ). CACS (coronary artery calcium score) was measured using cardiac computed tomography. CAC was defined as CACS > 100. RESULTS: CAC was found in 334 (21.8%) patients, and was more prevalent in the lower eGFR groups (p < 0.001). In multivariate Tobit regression, CACS increased gradually as eGFRC rC ys decreased (p for trend = 0.034). In multivariate logistic regression, there were gradual associations between lower eGFR and CAC when an eGFRC ys or eGFRC rC ys was used. The adjusted OR for CAC in the group with eGFR < 30 ml/min/1.73m2 compared to the group with eGFR ≥ 90 ml/min/1.73m2 was 2.64 (95% CI, 1.09-3.60) when eGFRC rC ys was used. Of the four eGFR formulas, only adding eGFRC rC ys significantly improved CAC prediction models without eGFR (p = 0.046). CONCLUSIONS: There was a gradual and independent association between low eGFR and CAC in a predialysis CKD cohort in Korea. eGFRC rC ys predicted CAC better than other equations in this population. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: The independent association between eGFR and coronary artery calcification (CAC) is complex and not clear. The aim of this study is to investigate the relationship between eGFR calculated from different equations and CAC in predialysis CKD patients in Korea. METHODS: In this cross-sectional study, we analyzed 1,533 patients from the KNOW-CKD cohort. eGFR was calculated by a four-variable MDRD equation (eGFRMDRD ), CKD-EPI creatinine equations (eGFRC r ), CKD-EPI Cystatin C equation (eGFRC ys ), and CKD-EPI Creatinine-Cystatin equation (eGFRC rC ys ). Participants were divided into eGFR categories (< 30, 30-59, 60-89, ≥ 90 ml/min/1.73 m2 ). CACS (coronary artery calcium score) was measured using cardiac computed tomography. CAC was defined as CACS > 100. RESULTS: CAC was found in 334 (21.8%) patients, and was more prevalent in the lower eGFR groups (p < 0.001). In multivariate Tobit regression, CACS increased gradually as eGFRC rC ys decreased (p for trend = 0.034). In multivariate logistic regression, there were gradual associations between lower eGFR and CAC when an eGFRC ys or eGFRC rC ys was used. The adjusted OR for CAC in the group with eGFR < 30 ml/min/1.73m2 compared to the group with eGFR ≥ 90 ml/min/1.73m2 was 2.64 (95% CI, 1.09-3.60) when eGFRC rC ys was used. Of the four eGFR formulas, only adding eGFRC rC ys significantly improved CAC prediction models without eGFR (p = 0.046). CONCLUSIONS: There was a gradual and independent association between low eGFR and CAC in a predialysis CKD cohort in Korea. eGFRC rC ys predicted CAC better than other equations in this population. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
zzm321990eGFRzzm321990; chronic kidney disease; coronary artery calcification; renal function