(from the Chronic Renal Insufficiency Cohort Study)

disease (CKD) are at markedly increased risk for cardiovascular mortality, the relation between CKD and aortic valve calcification not been elucidated. Also, few data are available on the relation of aortic valve calcification and earlier stages of CKD. We sought to assess the relation of aortic valve calcium (AVC) with estimated glomerular filtration rate (eGFR), traditional and novel cardiovascular risk factors, and markers of bone metabolism in the Chronic Renal Insufficiency Cohort (CRIC) Study. All patients who underwent aortic valve scanning in the CRIC study were included. The relation between AVC and eGFR, traditional and novel cardiovascular risk factors, and markers of calcium metabolism were analyzed using both unadjusted and adjusted regression models. A total of 1,964 CRIC participants underwent computed tomography for AVC quantification. Decreased renal function was independently associated with increased levels of AVC (eGFR 47.11, 44.17, and 39ml/ min/1.73 m2, respectively, p <0.001). This association persisted after adjusting for traditional, but not novel, AVC risk factors. Adjusted regression models identified several traditional and novel risk factors for AVC in patients with CKD. There was a difference in AVC risk factors between black and nonblack patients. In conclusion, our study shows that eGFR is associated in a dose-dependent manner with AVC in patients with CKD, and this association is independent of traditional cardiovascular risk factors. Abstract Background: Although subjects with chronic kidney disease (CKD) are at markedly increased risk for cardiovascular mortality, the impact of CKD on aortic valve calcification (AVC) has not been fully elucidated. Also, few data are available on the relationship of AVC and earlier stages of CKD. We sought to assess the relationship of AVC with eGFR, traditional and novel cardiovascular risk factors, and markers of bone metabolism in the Chronic Renal Insufficiency Cohort (CRIC) Study. Methods: All patients who underwent aortic valve scanning in the CRIC study were included. The relationship between AVC and eGFR, traditional and non-traditional cardiovascular risk factors, and markers of calcium metabolism were analyzed using both adjusted and unadjusted regression models. Results: A total of 1964 CRIC baseline participants underwent CT for AVC quantification. AVC was inversely associated with eGFR (P<0.001), and there was a graded relationship between decreased renal function and increased levels of AVC. Adjusted regression models identified several traditional and novel risk factors for AVC in patients with CKD. There was a difference in AVC risk factors between black and non-black patients. Conclusions: Our study shows that eGFR is a risk factor for AVC in patients with CKD, which is independent of traditional cardiovascular risk factors.

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