Calcification of the Thoracic Aorta and Its Segments and Chronic Kidney Disease in Participants of the ELSA-Brasil Cohort.

Abstract

Introduction: Aortic calcification may be a vascular marker of health risk. Loss of elastic recoil due to arterial calcification results in hemodynamic changes that, in turn, can lead to damage to target organs, such as the kidneys. There are few studies analyzing the association between the presence of calcification in the thoracic aorta and chronic kidney disease (CKD).

Objective: To investigate the association between calcification of transthoracic aortic (TAC) and its segments and CKD in individuals living in the community without established cardiovascular disease and to verify whether arterial stiffness is a confounder of this relationship.

Methods: Cross-sectional study with 2427 participants from visit 2 of ELSA-Brasil, in Minas Gerais (2012-2015). TAC and its ascending (ATAC), aortic arch (AAC), and descending (DTAC) segments were categorized by the degree of calcification (0; greater than 0 and less than 100 HU; and greater than 100 HU). The presence of CKD was verified by glomerular filtration rate (eGFR CKDEPI) < 60 mL/min/1.73 m² and/or albumin/creatinine ratio ≥ 30 mg/g. The adjustment covariates were age, sex, race/color, schooling, smoking, cholesterol/HDL ratio, BMI, diabetes, hypertension, and pulse wave velocity (PWV). Logistic regression models were performed to analyze the associations. Statistical significance was defined as p < 0.05.

Results: After all adjustments, there was an association between DTAC and CKD in the group with the highest degree of calcification (OR: 2.66-1.05; 6.71). The inclusion of PWV in the final model slightly increased the magnitude of the association with DTAC (OR: 2.75; 1.07-7.05). No statistical association was found for TAC, ATAC, and AAC.

Conclusion: Greater degree of DTAC is positively associated with CKD, regardless of the level of arterial stiffening.