MP372THE RELATIONSHIP BETWEEN ABDOMINAL AORTIC CALCIFICATION SCORE AND GLOMERULAR FILTRATION RATE IN PATIENTS WITH CHRONIC KIDNEY DISEASE 3-5

Abstract

INTRODUCTION AND AIMS: Abdominal aortic calcification (AAC) is an important risk factor for cardiovascular events. Few studies have been conducted in patients with chronic kidney disease (CKD) 3-5. Our aim was to analyze the relationship between AAC score and measured GFR in patients with CKD 3-5 and evaluate other potential risk factors. METHOD(S): This is a baseline data analysis of a randomized controlled clinical trial (RENEXC). 151 adult patients with eGFR (estimated GFR) < 30ml/min/1.72m2, not on renal replacement therapy, irrespective of number of comorbidities were included from the Department of Nephrology, Skane University Hospital, Lund, from 2011 to 2016. GFR was measured by iohexol clearance. AAC was evaluated by lateral lumbar X-ray and using the scoring system described by Kauppila to calculate the AAC score. Calcific deposits were graded on a scale of 0-3 at each segment: 0=no calcific deposits, 1=calcific deposits filling less than 1/3 of the aortic wall, 2=1/3 to 2/3 of the aortic wall calcified, 3=more than 2/3 of the aortic wall calcified. The grades of four segments (Lumbar 1- Lumbar 4) were summed, ranging from 0-24. 24-hour-blood pressure was measured. Pulse pressure was calculated using systolic blood pressure minus diastolic blood pressure. We calculated pulse pressure day and night separately. Multiple linear regression analysis was performed to analyze the relationships between variables. Data were analyzed using R software (R foundation for Statistical Computing, Vienna, Austria). The level of significance was set at p<0.05. RESULT(S): The patients' age ranged from 19 to 87, with a mean age of 66 years (98 men and 53 women). The measured GFR ranged from 8 to 55 ml/min/1.73m2, with an average of 22.5 +/- 8.2 ml/min/1.73m2. The prevalence of AAC in this group of patients was 85%. After adjusting for sex, age and cardiovascular disease (CVD), AAC score was negatively associated with GFR (p<0.05), and positively associated with pulse pressure day (p<0.05) but no significant relationship was found with pulse pressure night. We found no significant relationships between AAC score and plasma phosphate, serum triglycerides or cholesterol. CONCLUSION(S): AAC was highly prevalent in patients with CKD 3-5 and strongly related with age and cardiovascular disease. Higher AAC score was significantly related to GFR decline and increased pulse pressure day.