Renal Division, Emory University School of Medicine, Atlanta, GA 30322, USA.
Clin J Am Soc Nephrol. 2012 Feb;7(2):275-9. doi: 10.2215/CJN.06490711. Epub 2011 Dec 8.
CKD is a risk factor for medial artery calcification, but the CKD stage at which this risk begins is unknown. Because breast arterial calcification (BAC) is a marker of generalized medial arterial calcification, mammography was used to detect medial arterial calcification in women with different CKD stages.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a retrospective, cross-sectional study of women with and without CKD matched for age and diabetes and identified from mammograms obtained in 2006-2011. BAC was scored as present or absent per visual inspection.
A total of 146 women with stage 3 CKD and 54 with stage 4/5 CKD were identified. An additional 21 patients with ESRD were identified and added to a previous cohort of 71 patients. Mean age was 64 years for CKD 3, 63 for CKD 4, and 59 for ESRD. Half of each group had diabetes. Compared with controls, the odds ratios for BAC were 1.44 in CKD 3 (95% confidence interval [CI], 0.82-2.53), 2.69 in CKD 4 (95% CI, 1.14-6.33), and 7.19 in ESRD (95% CI, 3.77-13.7) and did not differ with diabetic status or race. In a multivariable logistic model, age (P<0.001) and estimated GFR (P=0.005) were independent predictors of BAC. The odds ratio for BAC increased 4% for each milliliter per minute per 1.73 m(2) decrease in estimated GFR. The prevalence of BAC in CKD was increased in each decade of age over 49 years.
CKD is an independent risk factor for medial arterial calcification.
慢性肾脏病（CKD）是动脉钙化的一个危险因素，但这种风险开始的 CKD 阶段尚不清楚。由于乳腺动脉钙化（BAC）是全身动脉钙化的一个标志物，因此本研究使用乳房 X 线照相术来检测不同 CKD 阶段女性的动脉钙化。
设计、地点、参与者和测量方法：这是一项回顾性、横断面研究，研究对象为年龄和糖尿病相匹配、并于 2006 年至 2011 年期间接受乳房 X 线照相术检查的有或无 CKD 的女性。BAC 是通过肉眼观察进行评分的。
共发现 146 名 CKD 3 期患者和 54 名 CKD 4/5 期患者。另外还发现了 21 名终末期肾病患者，并将其添加到之前的队列中，该队列中有 71 名患者。CKD 3 期、CKD 4 期和 ESRD 组的平均年龄分别为 64 岁、63 岁和 59 岁。每个组的一半患者有糖尿病。与对照组相比，CKD 3 期的 BAC 比值比为 1.44（95%可信区间 [CI]，0.82-2.53），CKD 4 期为 2.69（95% CI，1.14-6.33），ESRD 期为 7.19（95% CI，3.77-13.7），并且与糖尿病状态或种族无关。在多变量逻辑模型中，年龄（P<0.001）和估算肾小球滤过率（P=0.005）是 BAC 的独立预测因子。估算肾小球滤过率每降低 1 毫升/分钟/每 1.73 平方米，发生 BAC 的比值比增加 4%。49 岁以上每增加 10 年，CKD 患者 BAC 的患病率就会增加。
CKD 是动脉钙化的独立危险因素。
