Relation of Aortic Valve Calcium to Chronic Kidney Disease (from the Chronic Renal Insufficiency Cohort Study) Marie A. Guerraty, MD, PhDa,*, Boyang Chai, MSb, Jesse Y. Hsu, PhDb, Akinlolu O. Ojo, MD, MPH, PhDc, Yanlin Gao, MDd, Wei Yang, PhDb, Martin G. Keane, MDe, Matthew J. Budoff, MDd, and Emile R. Mohler III, MDf, the CRIC Study Investigators1 Although subjects with chronic kidney disease (CKD) are at markedly increased risk for cardiovascular mortality, the relation between CKD and aortic valve calcification has not been fully elucidated. Also, few data are available on the relation of aortic valve calcification and earlier stages of CKD. We sought to assess the relation of aortic valve calcium (AVC) with estimated glomerular filtration rate (eGFR), traditional and novel cardiovascular risk factors, and markers of bone metabolism in the Chronic Renal Insufficiency Cohort (CRIC) Study. All patients who underwent aortic valve scanning in the CRIC study were included. The relation between AVC and eGFR, traditional and novel cardiovascular risk factors, and markers of calcium metabolism were analyzed using both unadjusted and adjusted regression models. A total of 1,964 CRIC participants underwent computed tomography for AVC quantification. Decreased renal function was independently associated with increased levels of AVC (eGFR 47.11, 44.17, and 39 ml/min/1.73 m2, respectively, p 0 - 100 (n¼515) 62.26 262 253 192 323 149 43 31.73 105.01 198.37 281 118.78 6.73 478 127.75 68.64 59.10 463 100.84 50.16 151.24 44.18 0.94 0.15 0.60 0.04 4.85 2.37 7.21 14.17 12.69 9.30 3.75 63.15 47.00 26.82 24.50 38.65 23.65

(7.90) (51%) (49%) (37%) (63%) (29%) (8%) (6.58) (15.53) (125.59) (55%) (51.33) (1.52) (93%) (21.99) (12.11) (18.05) (90%) (34.99) (16.99) (97.79) (16.31) (2.01) (0.06 - 0.67) (1.39) (0.01 - 0.44) (7.29) (0.96 - 5.97) (1.87) (4.86) (1.69) (0.50) (0.67) (49.15) (32.90 - 76.50) (14.85) (14.10 - 36.95) (40.58) (8.20 - 61.00)

AVC þ AVRING >100 (n¼426)

p-value

66.53 190 236 138 288 176 40 31.72 106.81 178.24 252 116.36 6.64 409 132.28 66.44 65.88 401 99.76 46.80 156.50 39.03 1.05 0.18 0.69 0.05 5.48 2.64 7.51 16.55 12.57 9.33 3.73 75.53 54.45 25.77 23.80 39.59 23.00