Associations of Calciprotein Particle Maturation Time with Echocardiographic Measures in the CRIC Study.

INTRODUCTION

Vascular calcification is common in chronic kidney disease (CKD) and is associated with adverse cardiac outcomes. We investigated the relationship of T50, a measure of mineral stress that is associated with vascular calcification, with left ventricular (LV) echocardiographic abnormalities among patients with CKD in the Chronic Renal Insufficiency Cohort (CRIC).

METHODS

Linear regression models were used to examine the cross-sectional associations of T50 with LV mass index, and multinomial logistic regression models were used to analyze the cross-sectional associations of T50 with echocardiographic evidence of LV concentric remodeling, LV concentric hypertrophy, and LV eccentric hypertrophy. Multivariable models are adjusted for age, sex, race/ethnicity, clinical site, systolic blood pressure, body mass index, diabetes, smoking, history of cardiovascular disease, estimated glomerular filtration rate, and 24-h urinary protein.

RESULTS

Among 2,280 participants, mean age was 59 years and 47.0% were female; 28.5% showed evidence of LV concentric remodeling, 15.0% showed evidence of LV eccentric hypertrophy, and 36.3% showed evidence of LV concentric hypertrophy. In unadjusted model, each 1 standard deviation (1-SD) lower of T50 was associated with greater odds for eccentric hypertrophy and concentric hypertrophy. After sequential adjustment for demographics, clinical factors, and kidney function measures, these associations were lost for eccentric hypertrophy (OR per 1-SD lower: 1.09; 95% CI: 0.92-1.29) and concentric hypertrophy (OR per 1-SD lower: 1.05; 95% CI: 0.91-1.21). In the unadjusted model, each 1-SD lower of T50 was associated with increased LV mass index; this association was lost in the multivariable-adjusted model (β = 0.33; 95% CI: -0.63 to 1.28). Similar findings were observed when T50 was examined in quartiles.

CONCLUSION

Among the CRIC cohort, T50 was not associated with LV concentric remodeling, LV eccentric hypertrophy, or LV concentric hypertrophy after multivariable adjustment that included measures of kidney function.