Association of Body Weight Variability With Progression of Coronary Artery Calcification in Patients With Predialysis Chronic Kidney Disease.

Sang Heon Suh,Soo Wan Kim,Seung Hyeok Han,Suah Sung,Chang Seong Kim,Eun Hui Bae,Tae Ryom Oh,Kook-Hwan Oh,Kyu-Beck Lee,Hong Sang Choi,Seong Kwon Ma

doi:10.3389/fcvm.2021.794957

Abstract

BackgroundWe investigated whether high body weight variability (BWV) is associated with a higher prevalence of coronary artery calcification (CAC) or more rapid progression of CAC in patients with predialysis chronic kidney disease (CKD).MethodsA total of 1,162 subjects from a nationwide prospective cohort of predialysis CKD were analyzed. The subjects were divided into the tertile (T1, T2, and T3) by BWV. CAC was assessed at the baseline and a 4-year follow-up by CT scan. Rapid progression of coronary artery calcification was defined as an increase in coronary artery calcium score (CACS) more than 200 Agatston units during a 4-year follow-up.ResultsOne-way ANOVA revealed that CACS change during the follow-up period is significantly higher in the subjects with high BWV, although CACS at the baseline and 4-year follow-up was not different among the tertile groups by BWV. Logistic regression analysis revealed that compared to low BWV (T1), both moderate (T2, adjusted odds ratio (OR) 2.118, 95% CI 1.075–4.175) and high (T3, adjusted OR 2.602, 95% CI 1.304–5.191) BWV was associated with significantly increased risk of rapid progression of CAC. Importantly, the association between BWV and progression of CAC remained robust even among the subjects without significant BW gain or loss during follow-up periods (T2, adjusted OR 2.007, 95% CI 1.011–3.984; T3, adjusted OR 2.054, 95% CI 1.003–4.207).ConclusionHigh BWV is independently associated with rapid progression of CAC in patients with predialysis CKD.

Highlights

Patients with chronic kidney disease (CKD) are likely to experience body weight (BW) fluctuation
We investigated whether high body weight variability (BWV) is associated with a higher prevalence of coronary artery calcification (CAC) or more rapid progression of CAC in patients with predialysis chronic kidney disease (CKD)
Logistic regression analysis revealed that compared to low bodyweight variability (BWV) (T1), both moderate (T2, adjusted odds ratio (OR) 2.118, 95% CI 1.075–4.175) and high (T3, adjusted odds ratios (ORs) 2.602, 95% CI 1.304–5.191) BWV was associated with significantly increased risk of rapid progression of CAC

Summary

Introduction

Patients with chronic kidney disease (CKD) are likely to experience body weight (BW) fluctuation. Diuretic use further increases the odd for BW fluctuation in patients with CKD [8] As all these conditions are likely to take place concurrently, it is expected that bodyweight variability (BWV), rather than persistent loss or gain of BW, maybe of high clinical significance, which has not been established especially in patients with predialysis CKD. It is noticeable that the association of high BWV with adverse CV outcomes is independent of traditional CV risk factors [15, 17], suggesting a potential role of BWV in the prediction of outcomes in patients with CKD. We investigated whether high body weight variability (BWV) is associated with a higher prevalence of coronary artery calcification (CAC) or more rapid progression of CAC in patients with predialysis chronic kidney disease (CKD)

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Conclusion