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Abstract: SA-PO518

Association Between Progression of Coronary Artery Calcification and Development of Kidney Failure with Replacement Therapy: Findings from KNOW-CKD Study

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Park, Cheol Ho, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Kim, Hyung Woo, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Park, Jung Tak, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Chang, Tae ik, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
  • Yoo, Tae-Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Kang, Shin-Wook, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  • Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
Background

A higher burden of coronary artery calcification (CAC) is a strong risk factor of adverse cardiovascular and kidney outcomes. However, clinical implications of longitudinal change in CAC remain unknown. Here, we evaluated whether the progression of coronary artery calcification can predict development of kidney failure with replacement therapy (KFRT).

Methods

A total of 1,173 participants with chronic kidney disease (CKD) G1 to G5 without kidney replacement therapy were included from KNOW-CKD (Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease). Participants were categorized into 3 groups according to the change in CAC score between baseline and year 4 (non-progressors, ≤0 AU; moderate progressors, 1–199 AU; severe progressors ≥200 AU). The primary outcome was the development of KFRT.

Results

During a follow-up period of 4,690 person-years (median, 4.2 years), the primary outcome occurred in 230 (19.6%) participants. The incidence of KFRT was 37.6, 54.3, and 80.9 per 1000 person-years in non-, moderate, and severe progressors, respectively. In multivariable cause-specific hazard model, the hazard ratios (HRs) for the moderate and severe progressors were 1.77 (95% CI, 1.06–2.95) and 2.52 (95% CI, 1.06–6.00), respectively, compared with non-progressors. A sensitivity analysis using a different definition of CAC progression, with a threshold of 100 AU, also yielded similar results.

Conclusion

The progression of CAC was associated with an increased risk for development of KFRT in patients with CKD.

Funding

  • Government Support – Non-U.S.