Renal artery calcium: relationship to systemic calcified atherosclerosis

Abstract

Abstract:In this study we tested the hypothesis that calcium due to atherosclerosis in the renal arteries would be significantly associated with calcium in multiple other vascular beds, independent of traditional risk factors for cardiovascular disease (CVD). Electron beam computed tomography was conducted in 1461 consecutive asymptomatic patients free of clinical CVD to determine the presence and extent of calcium in the renal arteries, coronary and non-coronary vasculature and the aortic and mitral annuli. The overall prevalence for calcium in either renal artery was 18.0%, with men having a significantly higher prevalence (20.2%) than women (15.0%) [p ϭ 0.01]. Renal artery calcium (RAC) was significantly correlated with calcium located in the carotids, coronaries, thoracic aorta, abdominal aorta and iliac arteries and calcium in the mitral and aortic annuli (r range ϭ 0.22-0.37). In a multivariable model containing the traditional CVD risk factors, the presence of calcium in the renal arteries was significantly associated with age, male sex and a diagnosis of hypertension. After adjustment for these variables, the presence of calcium in the thoracic or abdominal aorta was significantly associated with RAC (OR ϭ 2.1 and 2.0, respectively; p Ͻ 0.01 for both). The sensitivity for prevalent RAC was highest in those individuals with any calcium in the abdominal aorta (94.5%). In conclusion, calcium related to atherosclerosis in the renal arteries is highly associated with atherosclerotic calcification in other vascular beds, especially the aorta, and the valvular annuli. These relationships are independent of traditional CVD risk factors.

Correlation between coronary and valve calcification: Review of current evidence

“…studies of asymptomatic subjects by Allison et al found that calcification of all arterial beds was a significant predictor of MAC with the exception of the coronary, iliac and renal arteries, while the presence of abdominal aorta calcification gave the highest odds for MAC 110,111 . Nevertheless, other studies have found a strong association between the presence and extent of MAC and presence and progression of CAC 112,113 , although the prevalence of CAC appears to be much higher than prevalence of MAC (50% vs 9%) 114 .…”

“…In asymptomatic subjects, the presence of calcium in the abdominal aorta had the highest sensitivity for any renal artery calcification (94.5%) 49 . Risk factors were rarely assessed and generally it is only age and male gender, possibly with hypertension, that are consistently associated 50,51,52 , although, curiously, low body mass index and low diastolic blood pressure were risk factors for presence and extent respectively of subclavian artery calcification 53 .…”

“…Nevertheless, studies of asymptomatic subjects show a good correlation between calcification of the combined annuli and most vascular beds 66,67 , with calcification of the thoracic aorta being the strongest correlation 68 , while renal artery calcification presence appears to be associated with AVC but not with MAC 69 . In asymptomatic subjects, aortic valve calcification is more prevalent than MAC, with incidence up to three times higher 70,71 , while in symptomatic patients there were almost equal numbers with MAC and AVC…”

The prevalence and distribution of the atherosclerotic plaques in the abdominal aorta and its branches

“…According to the study of Aggarwal et al [1], atherosclerotic plaques were found in 75% of renal arteries in the fourth decade, in 85% in the fifth decade, in 70% in the sixth decade and in 100% in the seventh decade. Renal artery calcium was also significantly associated with age [3]. In the literature, some of the studies claimed that the plaques were not correlated with age [13].…”

Evaluation of the Tp-e Interval and Tp-e/QT Ratio in Patients with Mitral Annular Calcification

“…It has previously been reported that patients with MAC have a higher prevalence of coronary artery disease, arrhythmias, aortic valve calcification, and cerebrovascular diseases [2][3][4]. MAC and atherosclerosis have similar risk factors including old age, hypertension, diabetes, and obesity; it is hypothesized that the presence of MAC reflects the duration and intensity of exposure to these risk factors [5]. Myocardial repolarization abnormalities are correlated with ventricular arrhythmias and high cardiovascular mortality.…”