Coronary Artery Calcification Score and the Progression of Chronic Kidney Disease

Hae Ryong Yun, Young Su Joo, Hyung Woo Kim, Jung Tak Park, Tae Ik Chang, Nak Hoon Son, Tae Hyun Yoo, Shin Wook Kang, Suah Sung, Kyubeck Lee, Joongyub Lee, Kook Hwan Oh, Seung Hyeok Han

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2 Citations (Scopus)


Background Elevated coronary artery calcification scores (CACS) are associated with increased cardiovascular disease risk in patients with chronic kidney disease (CKD). However, the relationship between CACS and CKD progression has not been elucidated. Methods We studied 1936 participants with CKD (stages G1–G5 without kidney replacement therapy) enrolled in the KoreaN Cohort Study for Outcome in Patients With CKD. The main predictor was Agatston CACS categories at baseline (0 AU, 1–100 AU, and >100 AU). The primary outcome was CKD progression, defined as a ≥50% decline in eGFR or the onset of kidney failure with replacement therapy. Results During 8130 person-years of follow-up, the primary outcome occurred in 584 (30.2%) patients. In the adjusted cause-specific hazard model, CACS of 1–100 AU (hazard ratio [HR], 1.29; 95% confidence interval [95% CI], 1.04 to 1.61) and CACS >100 AU (HR, 1.42; 95% CI, 1.10 to 1.82) were associated with a significantly higher risk of the primary outcome. The HR associated with per 1-SD log of CACS was 1.13 (95% CI, 1.03 to 1.24). When nonfatal cardiovascular events were treated as a time-varying covariate, CACS of 1–100 AU (HR, 1.31; 95% CI, 1.07 to 1.60) and CACS >100 AU (HR, 1.46; 95% CI, 1.16 to 1.85) were also associated with a higher risk of CKD progression. The association was stronger in older patients, in those with type 2 diabetes, and in those not using antiplatelet drugs. Furthermore, patients with higher CACS had a significantly larger eGFR decline rate. Conclusion Our findings suggest that a high CACS is associated with significantly increased risk of adverse kidney outcomes and CKD progression.

Original languageEnglish
Pages (from-to)1590-1601
Number of pages12
JournalJournal of the American Society of Nephrology
Issue number8
Publication statusPublished - 2022 Aug

Bibliographical note

Funding Information:
Funding: This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, and 2016E3300200). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2022 American Society of Nephrology. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Nephrology


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