Dua, R., Nguyen, B.L., Sangla, K.S., and Golledge, J. (2011) Age and serum calcium are associated wih infra-renal aortic calification in patients with chronic kidney disease. Nephrology, 16 (s1). 230. p. 84.

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Abstract

Aim: To access the determinants of infra-renal aortic calcifi cation in patients with Chronic Kidney disease (CKD).

Background: Infra-renal aortic calcification is associated with increased cardiovascular morbidity. Few studies have investigated this in CKD patients with most reports failing to use validated methods of quantifying calcification severity.

Methods: We estimated infra-renal aortic calcification in 58 CKD patients (39 dialysis, 19 non dialysis) who had undergone abdominal aortic Computed Tomography. Infra-renal aortic calcification volume was estimated using a previously validated highly reproducible semi automated method. Clinical risk factors and co-morbidities (age, atherosclerotic risk factors, medications), serum creatinine, corrected serum calcium and phosphate concentrations were assessed. The association of these risk factors with aortic calcification was analyzed using both univariate and multivariate statistical tests.

Results: In all 58 patients aortic calcification severity was strongly correlated with age (Spearman correlation coefficient (r) = 0.680, P < 0.001), but only weakly correlation with eGFR (r = 0.218, P = 0.103) and serum creatinine (r = −0.231, P = 0.084). Patients that required dialysis were much younger [n = 39, median age 58 years, IQR 49–67] than those not on dialysis [n = 19, median age 73 years IQR 66–78] and thus were analyzed separately. In patients receiving dialysis use of calcium based phosphate binders was associated with less calcification [median calcification volume 14 cm3, IQR 0–361, compared to 570 cm3, 2–2468, P = 0.022]. On regression analysis the only factors associated with aortic calcification were age (beta 0.482, P = 0.004) and corrected serum calcium concentrations (beta 0.368, P = 0.012).

Conclusion: In this study the principle risk factor for aortic calcification was age. Serum calcium concentrations and use of calcium based phosphate binders may also influence calcification in patients on dialysis but larger studies are required to better assess this.

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