SUN-101 PREVALENCE AND CORRELATES OF CARDIOVASCULAR CALCIFICATION AND ITS PROGNOSTIC EFFECTS AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE: RESULTS FROM THE C-STRIDE STUDY

Abstract

Cardiovascular calcification is highly prevalent in patients with chronic kidney disease (CKD) and is predictive of cardiovascular disease (CVD). To date, most studies have focused on Abdominal aortic calcification (AAC) and cardiac valve calcification (CVC) found in dialysis patients. However, information regarding AAC and CVC in non-dialysis CKD patients is limited. We hypothesized that there is a close association between vascular calcification and the prognosis of non-dialysis CKD patients. To test this hypothesis, we conducted a multicenter prospective study to identify the characteristics and risk factors associated with cardiovascular calcification, and its relationship to prognosis, in patients with CKD stages 1 to 4. The C-STRIDE is an ongoing multicenter prospective study lead by the Peking University First Hospital that includes 39 clinical centers located in 28 cities in 22 provinces of China. It strictly adhered to the Helsinki declaration, and all participants signed written informed consent. Cardiovascular calcification was evaluated at baseline by lateral abdominal radiography to detect aortic calcifications, and by echocardiogram to detect valvular calcifications, respectively. We prospectively followed up over more than five years with 3168 CKD patients in the C-STRIDE study. Demographic and laboratory data were collected and analyzed. Among 3168 patients from the C-STRIDE study, a subgroup of 2235 patientswas selected to undergolateral abdominal radiography and a second subgroup of 2756 patients was selected toundergoechocardiography. AAC was present in 206 patients (9.22%) and CVC was present in 163 patients (5.91%). Age, gender, history of CVD, smoking, hypertension, diabetes, levels of hemoglobin, low-density lipoprotein cholesterol and uric acid were associated with presence of AAC, while only age, history of CVD, levels of serum albumin and low-density lipoprotein cholesterol were associated with presence of CVC (all p-values<0.05) (Table 1 & 2). Survival analyses showed that cardiovascular events and all-cause mortality were significantly greater in patients with AAC or with CVC (all p-values for log-rank tests<0.05) (Table 3 & 4). However, there is no significant associations between presence of AAC or CVC and the outcomes in the multivariable Cox regression analysis after adjustment for age and sex. Demographic and traditional cardiovascular risk factors were associated with cardiovascular calcification, especially AAC. However, the presence of cardiovascular calcification cannot predict the future risk of cardiovascular events in the current study.