Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Renal Disease
Systemic Inflammation Is Associated With Coronary Artery Calcification and All-Cause Mortality in Chronic Kidney Disease
In-Chang HwangHyo Eun ParkHack-Lyoung KimHyue Mee KimJun-Bean ParkYeonyee E. YoonSeung-Pyo LeeHyung-Kwan KimGoo-Yeong ChoDae-Won SohnYong-Jin Kim
Author information
JOURNAL FREE ACCESS FULL-TEXT HTML
Supplementary material

2016 Volume 80 Issue 7 Pages 1644-1652

Details
Abstract

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 m2) 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 m2) 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)

Content from these authors
© 2016 THE JAPANESE CIRCULATION SOCIETY
Previous article Next article
feedback
Top