Evaluating the Independent Impact of Renal Function Decline onCoronary Artery Calcification in Patients Undergone Cardiac CT Scan

Background: cardiovascular events are the leading global cause of death. calcification of coronary arteries is a common compli-cation of renal failure and the leading cause of death in this population. however, its multifactorial mechanism is not fully under-stood.objectives: the current study aimed to, firstly, investigate the association between renal dysfunction and the calcification of coro-nary arteries in patients with severe and milder stages of renal failure and, secondly, to determine the role of this variable by elimi-nating the e ect of established confounding factors.methods: following a retrospective design, 261 patients with cardiovascular risk factors or atypical symptoms were investigated. estimated gfr (glomerular filtration rate) was calculated using both cockcroft-gault and mdrd equations. an ecg-gated multi-detector ct scan was performed to calculate cacs (coronary artery calcification score) using the agatston method. the presence of significant cac (coronary artery calcification) was defined as cacs > 100. univariate and multivariate analyses were performed using binary logistic regression.results: a total of 134 cases were diagnosed with cac, and the mean cacs was 83.4 ± 18. according to univariate analysis, older age, male gender, systolic and diastolic blood pressure, and higher tg levels were correlated with the degree of cac. hba1c showed a weak correlation with cacs (p-value = 0.04). renal insuÿciency resulted in increased cac, and lower egfr (calculated with both cockgraft-gault and mdrd equations) was associated with higher calcification (p-value < 0.01). our analysis shows that serum ca, p, ldl, and hdl levels do not have a significant influence on calcification changes. after adjusting for confounding factors, male sex, age, triglyceride level, and egfr were recognized as independent risk factors for cacs ≥ 100, a marker of coronary artery atheroscle-rosis. however, hba1c and systolic and diastolic blood pressure were no longer considered as factors that contribute to the risk of cac.conclusions: we observed a gradual and independent association between lower egfr and higher cac scores.