The Risk for Medial Arterial Calcification in CKD

Background and objectives CKD is a risk factor for medial artery calcification, but the CKD stage at which this risk begins is unknown. Because breast arterial calcification (BAG) is a marker of generalized medial arterial calcification, mammography was used to detect medial arterial calcification in women with different CKD stages. Design, setting, participants, & measurements This was a retrospective, cross-sectional study of women with and without CKD matched for age and diabetes and identified from mammograms obtained in 2006-2011. BAG was scored as present or absent per visual inspection. Results A total of 146 women with stage 3 CKD and 54 with stage 4/5 CKD were identified. An additional 21 patients with ESRD were identified and added to a previous cohort of 71 patients. Mean age was 64 years for CKD 3, 63 for CKD 4, and 59 for ESRD. Half of each group had diabetes. Compared with controls, the odds ratios for BAG were 1.44 in CKD 3 (95% confidence interval [CI], 0.82-2.53), 2.69 in CKD 4 (95% Cl, 1.14-6.33), and 7.19 in ESRD (95% CI, 3.77-13.7) and did not differ with diabetic status or race. In a multivariable logistic model, age (P<0.001) and estimated GFR (P=0.005) were independent predictors of BAG. The odds ratio for BAG increased 4% for each milliliter per minute per 1.73 m(2) decrease in estimated GFR. The prevalence of BAG in CKD was increased in each decade of age over 49 years. Conclusions CKD is an independent risk factor for medial arterial calcification. Clin J Am Soc Nephrol 7: 275-279, 2012. doi: 10.2215/CJN.06490711