High estimated glomerular filtration rate is associated with coronary artery calcification in middle-aged Korean men without chronic kidney disease

Background: High estimated glomerular filtration rate (eGFR) as well as low eGFR is associated with cardiovascular morbidity and mortality. Vascular calcification is a suggested link between low eGFR and worse cardiovascular outcome. However, the association between high eGFR and vascular calcification is not known. The aim of this study is to investigate the relationship between high eGFR and coronary artery calcification (CAC).

Methods: This cross-sectional study analyzed middle-aged Korean men in whom coronary artery calcium scores (CACS) and eGFR were measured as part of a health examination program in Korea. Participants with underlying chronic kidney disease (CKD), cardiovascular disease (CVD) and cancer were excluded. CAC was defined as a CACS >100.

Results: Among 6986 subjects [age 48.1 (46.5-50.5) years], 321 (4.6%) participants had CAC. The percentages of participants with CAC were 5.7, 3.8, 4.9 and 6.6 in groups with eGFR (mL/min/1.73 m(2)) of 60 ∼ 74, 75 ∼ 89, 90 ∼ 104 and 105 ∼ max, respectively. According to multivariate analysis, the odds ratio for CAC in the group with eGFR of 105 ∼ max compared with the group with eGFR of 75 ∼ 89 was 2.52 (1.67-3.79, P < 0.001) after adjustment for age, body mass index, diabetes, hypertension, systolic blood pressure, glucose, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, hsCRP, calcium, phosphorus, current smoking, alcohol intake and vigorous exercise frequency.

Conclusions: High eGFR is associated with CAC in middle-aged Korean men without CKD. Further studies are needed to verify a causal relationship and clarify the role of high eGFR in the development of CVD.