Is chronic kidney disease associated with coronary artery stenosis or calcification as assessed by multi-detector row computed tomography?

Abstract

Background: The coronary artery calcification (CAC) score as determined by multi-detector row computed tomography (MDCT) is known to predict coronary artery disease (CAD). Chronic kidney disease (CKD) is also known to be a risk factor for CAD. Little is known about the relationship between CKD and the severity of coronary artery stenosis or CAC as determined by MDCT, a non-invasive method for screening. Methods and Results: The subjects included 313 consecutive patients who underwent MDCT angiography. We quantified the number of significantly stenosed vessels in coronary vessel disease (VD) and CAC score using MDCT and measured body mass index (BMI), waist circumference and blood pressure. We also analyzed plasma levels of lipid profile, hemoglobin A1c, uric acid, and creatinine. Furthermore, we calculated the estimated glomerular filtration rate (eGFR), and defined CKD as GFR <60 mL/min/ 1.73 m2. eGFR levels in the 3-VD group were significantly lower than those in patients without stenosed vessels. In the two classifications that were based on the CAC score [low (L, 0-444) and high (H, ≥445)] in our previous report, the H group was significantly associated with age, number of VD, incidence of hypertension and CKD. Multivariate logistic regression analysis revealed that the high CAC score group was significantly correlated with age (p=0.0023), CKD (p=0.0109) and number of VD (p=0.0470). Conclusion: CKD may contribute to the severity of CAD associated with the progression of CAC. Therefore, therapeutic intervention for CKD, in addition to the improvement of conventional risk factors, is needed to prevent CAD when MDCT is performed. © 2008 The Japanese Society of Internal Medicine.