Renal artery calcium (RAC) has been shown to be associated with higher odds of hypertension
(HTN). The purpose of this study was to determine if the presence and extent of RAC
is associated with renal function. We analyzed cross-sectional data from the Multi-Ethnic
Study of Atherosclerosis (MESA). A subsample of 1,226 participants underwent computed
tomography of the abdomen and also had venous blood samples measured for kidney function.
RAC was the primary predictor variable and the following measures of kidney function
were the outcome variables: estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine
ratio (UACR), and chronic kidney disease (CKD) stage. The analyses were adjusted for
age, gender, race, height, visceral fat, dyslipidemia, diabetes, cigarette smoking,
hypertension, interleukin-6 and abdominal aortic calcium (AAC). The average age of
this cohort was 66.1 years (SD 9.7), 44.8% (549 of 1,226) were men, and nearly 30%
had RAC >0. Compared with those with no RAC, those with RAC >0 were significantly
older but not different by gender or race. After adjustment for age, gender, and race,
those with RAC >0 had significantly higher visceral fat, were more likely to have
dyslipidemia, diabetes, and hypertension, had a higher interleukin-6, and a higher
prevalence of AAC >0. The mean eGFR and UACR among those without RAC were 80 ml/min/1.73 m2 and 21 mg/g, whereas these values were 78 ml/min/1.73 m2 and 55 mg/g among those with RAC. In fully adjusted multivariable linear regression
models, the presence of RAC was associated with a lower eGFR (β = −2.21, p = 0.06)
but not with UACR (β = 0.02, p = 0.79). In fully adjusted ordinal logistic regression,
RAC as a continuous variable was associated with increased odds of being in a worse
CKD category (odds ratio 1.14, p = 0.05). When measured by eGFR and CKD stage, there
is a modest relation between RAC and kidney function. Further studies might involve
clinical trials to assess the role of intensive cardiovascular disease risk factor
management in patients with subclinical RAC to determine if this may prevent or delay
the development and progression of CKD.
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Article Info
Publication History
Published online: July 24, 2017
Accepted:
July 7,
2017
Received:
March 19,
2017
Footnotes
The MESA study is supported by contracts HHSN268201500003I , N01-HC-95159 , N01-HC-95160 , N01-HC-95161 , N01-HC-95162 , N01-HC-95163 , N01-HC-95164 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute , and by grants UL1-TR-000040 , UL1-TR-001079 , and UL1-TR-001420 from NCATS . Mr. Vashishtha, BA, is supported by NIH grant 1TL1TR001443 . Dr. Ix, MD, was supported by an AHA Established Investigator Award ( 14EIA18560026 ).
See page 1438 for disclosure information.
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