Serum uric acid is associated with coronary artery calcification in early chronic kidney disease: a cross-sectional study

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Authors: Miyeun Han ; Hyunsuk Kim ; Hyo Jin Kim ; Eunjeong Kang ; Yong-Soo Kim ; Kyu Hun Choi ; Soo Wan Kim ; Curie Ahn ; Kook-Hwan Oh

MeSH: Adult ; Aged ; Coronary Angiography ; Coronary Artery Disease / blood* ; Coronary Artery Disease / complications ; Coronary Artery Disease / diagnostic imaging ; Cross-Sectional Studies ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency, Chronic / blood* ; Renal Insufficiency, Chronic / complications ; Renal Insufficiency, Chronic / physiopathology ; Risk Factors ; Tomography, X-Ray Computed ; Uric Acid / blood* ; Vascular Calcification / blood* ; Vascular Calcification / complications ; Vascular Calcification / diagnostic imaging

Keywords: Chronic kidney disease ; Coronary artery calcification ; Coronary computed tomography ; Uric acid

Abstract: Background: Although uric acid (UA) is regarded as a risk factor for cardiovascular disease, whether UA is an independent risk factor contributing to coronary artery calcification in chronic kidney disease (CKD) is not well known. We evaluated whether UA level is associated with coronary artery calcium (CAC) score in a predialysis CKD cohort.

Methods: A total of 1,350 subjects who underwent coronary computed tomography as part of the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease were analysed. We conducted a logistic regression analysis to evaluate the association between UA and the presence of CAC.

Results: CAC was detected in 705 (52.2 %) patients, and the level of UA was significantly higher in CAC > 0 patients. UA showed a positive relationship with CAC > 0 in age- and sex-adjusted logistic regression analysis (Odds ratio (OR) 1.11, 95 % confidence interval (CI) 1.04-1.19, P = 0.003). However, UA showed no association with CAC > 0 in multivariate analysis. Further analysis showed that UA showed a positive association with CAC > 0 only in estimated glomerual filtration rate (eGFR) > 60 ml/min/1.73 m2 (OR 1.23, 95 % CI 1.02-1.49, P = 0.036) but not in eGFR 30-59 ml/min/1.73 m2 (OR 0.92, 95 % CI 0.78-1.08, P = 0.309) or < 30 ml/min/1.73 m2 (OR 0.92, 95 % CI 0.79-1.08, P = 0.426).

Conclusions: UA level was significantly associated with CAC in early CKD, but not in advanced CKD.