Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly.
Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly.
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DOI：
10.1161/jaha.120.019300
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发表时间：
2021-07-06
影响因子：
5.4
通讯作者：
Lee EY
中科院分区：
文献类型：
--
作者：
Park S;Cho NJ;Heo NH;Rhee EJ;Gil H;Lee EY
血管钙化与慢性肾脏疾病之间的关系是众所周知的。然而，血管钙化是否影响肾功能恶化仍不清楚。我们研究了冠状动脉钙化评分（CACS）表明血管钙化程度较高的个体肾功能是否恶化得更快。对 2010 年 1 月至 2012 年 7 月在我们机构（韩国天安市的一家三级教学医院）接受心脏计算机断层扫描的估计肾小球滤过率正常（> 60 mL/min / 1.73 m2）的个体进行回顾性评估。所有参与者的年龄都在 20 至 65 岁之间。在 739 名患者中，447 名、175 名和 117 名患者的 CACS 分别为 0、1 至 99 和 ≥100 单位。参与者被随访了 7.8 年（四分位距，5.5-8.8）年。当使用线性混合模型进行估计时，与 CACS 0 组患者相比，CACS ≥100 组患者的调整后年度估计肾小球滤过率下降得更快（调整后β，-0.40；95% CI，-0.80 至 -0.03）。 CACS ≥100 组中肾脏疾病：改善全球结果标准（估计肾小球滤过率类别下降，伴随估计肾小球滤过率下降 25% 或更多）的调整后风险比为 2.52 (1.13–5.61)。倾向评分匹配后，与 CACS 为 0 的患者 (1.9%) 相比，CACS ≥ 100 的患者中观察到更常见的肾脏结局 (13.2%)，具有统计学意义 (P=0.004)。我们的结果表明，CACS 较高的患者肾功能下降得更快，这表明血管钙化可能与慢性肾病进展有关。
The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS). Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m2) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5–8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted‐β, −0.40; 95% CI, −0.80 to −0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13–5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance (P=0.004). Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.