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A retrospective study on the association between pre-dialysis chronic kidney disease and coronary artery calcification among patients at St Luke's Medical Center

Maria Madeline Mallillin, Carina Dalay-Dizon. MD

Background: Cardiovascular disease causes a significant morbidity and mortality in patients with chronic kidney disease and coronary artery calcification causes the atherosclerosis. This study examined the association of pre-dialysis chronic kidney disease with coronary artery calcification score.

Methods: This is a retrospective cross-sectional study design. A total of 336 patients who underwent CAC scoring from January 2011-June 2014 were analyzed. The patients were divided into three groups: no CKD, mild CKD (stage 1-2 CKD) and moderate CKD (stage 3-4 CKD) using the KDIGO definition of chronic kidney disease and eGFR was computed using the CKD Epi equation. First, an unadjusted odds ratio was done followed by adjusted odds ratio which was adjusted for for co-variates which are related with coronary artery calcification. A multiple linear regression analysis was done for independent factors associated with coronary artery calcification scores.

Results: After adjustments for co-variates it was noted that moderate CKD was associated with the presence of CAC. Patients with moderate CKD were noted to be 2.5 times more likely ( p value <0.001 95% confidence interval) to have coronary artery calcification as compared with those who does not have chronic kidney disease. Patients with diabetes are 1.73 times more likely to have coronary artery calcification as compared with those who have no diabetes ( p value 0.002, 95% confidence interval 13.08 to 445.90) . The multiple linear regression analysis showed that eGFR, diabetes, age >60 years old and sex are significant predictors of coronary artery calcification.

Conclusion: Moderate CKD (stage 3 and 4) is associated with coronary artery calcification scores but not with mild CKD (stage 1 and 2). Diabetes, age >60 years old and females are also independent risk factors for coronary artery calcification.