Association of renal function with cardiac calcifications in older adults: the cardiovascular health study
Open Access
- 7 October 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in Nephrology Dialysis Transplantation
- Vol. 24 (3), 834-840
- https://doi.org/10.1093/ndt/gfn544
Abstract
Background. Aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) are highly prevalent in patients with end-stage renal disease. It is less well established whether milder kidney disease is associated with cardiac calcifications. We evaluated the relationships between renal function and MAC, aortic annular calcification (AAC) and AVS in the elderly. Methods. From the Cardiovascular Health Study, a community-based cohort of ambulatory adults ≥ age 65, a total of 3929 individuals (mean ± SD age 74 ± 5 years, 60% women) were evaluated with two-dimensional echocardiography. Renal function was assessed by means of creatinine-based estimated glomerular filtration rate (eGFR) and cystatin C. Results. The prevalences of MAC and AAC were significantly higher in individuals with an eGFR < 45 mL/ min/1.73 m 2 ( P < 0.01 for each), and cystatin C levels were significantly higher in individuals with MAC or AAC compared to individuals without these cardiac calcifications ( P < 0.001 for each). After multivariate-adjustment, an eGFR 2 was significantly associated with MAC [odds ratio 1.54 (95% CI 1.16–2.06), P = 0.003] and not associated with AAC [1.30 (0.97–1.74), P = 0.085] and AVS [1.15 (0.86–1.53), P = 0.355]. In addition, cystatin C levels were independently associated with MAC [odds ratio per SD 1.12 (1.05–1.21), P = 0.001] and not associated with AAC [1.07 (1.00–1.15), P = 0.054] and AVS [0.99 (0.93–1.06), P = 0.82]. Furthermore, the prevalence of multiple cardiac calcifications was higher in subjects with an eGFR < 45 mL/ min/1.73 m 2 and increased per quartile of cystatin C ( P -values < 0.001). In addition, a significant trend was observed between an eGFR < 45 mL/min/1.73 m 2 , increasing levels of cystatin C and the number of cardiac calcifications ( P < 0.05). Conclusions. In a community-based cohort of the elderly, moderate kidney disease as defined by an eGFR 2 and elevated levels of cystatin C was associated with prevalent MAC. In addition, a significant trend was observed between an eGFR 2 , increasing levels of cystatin C and the number of cardiac calcifications. No associations were found between renal function and AAC or AVS.Keywords
This publication has 28 references indexed in Scilit:
- Why we should sub-divide CKD stage 3 into early (3a) and late (3b) componentsNephrology Dialysis Transplantation, 2007
- Clinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. The Cardiovascular Health Study (CHS)American Heart Journal, 2006
- Cardiovascular Mortality Risk in Chronic Kidney DiseaseJAMA, 2005
- Epidemiology of mitral annular calcification and its predictive value for coronary events in African Americans: The Jackson Cohort of the Atherosclerotic Risk in Communities StudyAmerican Heart Journal, 2004
- Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and HospitalizationNew England Journal of Medicine, 2004
- Estimation of glomerular filtration rate in the elderly: a comparison of creatinine‐based formulae with serum cystatin CJournal of Internal Medicine, 2004
- Cardiac Valve Calcification as an Important Predictor for All-Cause Mortality and Cardiovascular Mortality in Long-Term Peritoneal Dialysis PatientsJournal of the American Society of Nephrology, 2003
- Cardiac calcification in adult hemodialysis patientsJournal of the American College of Cardiology, 2002
- Evaluation of the Dade Behring N Latex Cystatin C assay on the Dade Behring Nephelometer II SystemScandinavian Journal of Clinical and Laboratory Investigation, 1999
- The cardiovascular health study: Design and rationaleAnnals of Epidemiology, 1991