Association of mild to moderate kidney dysfunction and coronary calcification
Association of mild to moderate kidney dysfunction and coronary calcification
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DOI：
10.1681/asn.2007070765
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发表时间：
2008-03-01
影响因子：
13.6
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
--
作者：
Ix, Joachim H.;Katz, Ronit;Shlipak, Michael G.
冠状动脉钙化（CAC）在ESRD患者中普遍存在，并可预测死亡率，但不太严重的肾功能障碍是否与CAC相关尚不确定。为了解决这个问题，对6749名中年且无已知心血管疾病的多种族动脉粥样硬化研究参与者进行了评估。肾功能通过胱抑素C四分位数和估计GFR （eGFR <至60 ml/min / 1.73 m(2)）分类，CAC通过计算机断层扫描（CT）评估。50%的参与者患有CAC，平均胱抑素C为0.90 mg/L， 10%的参与者eGFR < 60 ml/min / 1.73 m(2)。在未经调整的分析中，两种方法的肾功能障碍都与CAC密切相关；然而，在调整年龄、性别、种族、高血压和IL-6后，相关性消失（最高半胱抑素C四分位数的相对风险为1.04[95%置信区间0.97至1.11]，最低四分位数的相对风险为1.03[95%置信区间0.98至1.08]，eGFR低于60 m/min与高于60 m/min / 1.73 m的相对风险为1.03[95%置信区间0.98至1.08）(2))。同样，高胱抑素C和eGFR < 60与CAC的严重程度无关。这些结果表明，较高的CAC负担不太可能解释轻度至中度肾功能障碍与心血管死亡率之间的关联。
Coronary artery calcification (CAC) is prevalent and predicts mortality among patients with ESRD, but whether less severe kidney dysfunction is associated with CAC is uncertain. To address this question, 6749 participants of the Multi-Ethnic Study of Atherosclerosis, who were middle-aged and without known cardiovascular disease, were evaluated. Renal function was categorized by cystatin C quartiles and estimated GFR (eGFR; < to > 60 ml/min per 1.73 m(2)), and CAC was evaluated by computed tomography (CT). Fifty percent of participants had CAC, mean cystatin C was 0.90 mg/L and 10% had eGFR < 60 ml/min per 1.73 m(2). In unadjusted analysis, kidney dysfunction by either measure was strongly associated with CAC; however, the associations were lost after adjustment for age, gender, race, hypertension, and IL-6 (relative risk 1.04 [95% confidence interval 0.97 to 1.11] for the highest cystatin C quartile compared with the lowest, and relative risk 1.03 [95% confidence interval 0.98 to 1.08) for eGFR below compared with above 60 m/min per 1.73 m(2)). Similarly, neither higher cystatin C nor eGFR < 60 was associated with severity of CAC. These results suggest that a higher burden of CAC is unlikely to explain the association between mild to moderate kidney dysfunction and cardiovascular mortality.