1. ¹Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
2. ²Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
3. ³Akershus University Hospital, Lorenskog and University of Oslo, Oslo, Norway, USA
4. ⁴Division of Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
5. ⁵Division of Nephrology, Department of Medicine, Veterans Affairs Medical Center, Dallas, Texas, USA

Correspondence: SS Hedayati, VA North Texas Health Care System, Nephrology Section, MC 111G1, 4500 South Lancaster Road, Dallas, Texas 75216-7167, USA. E-mail: susan.hedayati@med.va.gov

Received 11 June 2007; Revised 19 September 2007; Accepted 9 October 2007; Published online 12 December 2007.

Abstract

The increased burden of cardiovascular disease in chronic kidney disease cannot be explained by traditional risk factors alone. Here, we evaluated the impact of non-traditional factors on the association of chronic kidney disease with coronary artery calcification using logistic regression among 2672 Dallas Heart Study patients of whom 220 had chronic kidney disease. The prevalence of coronary calcification significantly increased across all chronic kidney disease stages and this remained independently associated with coronary calcification after adjusting for traditional factors. The calcium phosphorus product, homocysteine, and osteoprotegerin each diminished the magnitude of association between kidney disease and coronary calcification. After adjustment for these, the association between kidney disease and coronary calcification was no longer significant with the effects most prominent in the stages 3–5 subgroup. Our study has identified three non-traditional independent predictors of coronary calcification that diminished the association between chronic kidney disease and coronary calcification. These factors may represent novel mechanistic links warranting further investigation.