Skip to main content

Advertisement

SpringerLink
Log in

Arterial Location-Specific Calcification at the Carotid Artery and Aortic Arch for Chronic Kidney Disease, Diabetes Mellitus, Hypertension, and Dyslipidemia

  • Original Research
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Abstract

Several risk factors for arterial calcification have been reported but controversial. The aim of this study was to clarify the interactions among chronic kidney disease (CKD), diabetes mellitus (DM), hypertension, and dyslipidemia in altering the risk of arterial calcification in the three different arterial locations and the intramural location at the internal carotid artery (ICA) origins. Calcified burdens at the ICA origins, the aortic arch, and its orifices were evaluated in a retrospective fashion by using computed tomography angiography in 397 patients. The multivariate analyses were adjusted for age, gender, CKD, DM, hypertension, dyslipidemia, and current smoking status. Additionally, subgroup analyses in each variable were conducted. Our multivariate logistic regression analyses revealed that CKD was significantly associated with the outside-wall calcification at the ICA origins, whereas DM was only associated with the inside-ICA-wall calcification. Additionally, we found that DM increased the association between CKD and arterial calcification at the aortic arch and its orifices, and the outside-wall at the ICA origins. Hypertension was significantly associated with the calcification at the orifices of the aortic arch branches synergistically with CKD. Dyslipidemia did not have any significant association with calcification in any of the three vascular beds. CKD had the highest prevalence risk of calcification in common with the three different vascular beds. CKD in combination with DM, as well as hypertension in combination with CKD, were key relationships affecting the risk of arterial calcification, especially at the aortic arch and its orifices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Abedin M, Tintut Y, Demer LL (2004) Vascular calcification: mechanisms and clinical ramifications. Arterioscler Thromb Vasc Biol 24:1161–1170

    Article  CAS  PubMed  Google Scholar 

  2. Bellasi A, Raggi P (2012) Vascular imaging in chronic kidney disease. Curr Opin Nephrol Hypertens 21:382–388

    Article  PubMed  Google Scholar 

  3. Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM (2001) Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 38:938–942

    Article  CAS  PubMed  Google Scholar 

  4. Coll B, Betriu A, Martinez-Alonso M, Amoedo ML, Arcidiacono MV, Borras M, Valdivielso JM, Fernandez E (2011) Large artery calcification on dialysis patients is located in the intima and related to atherosclerosis. Clin J Am Soc Nephrol 6:303–310

    Article  PubMed Central  PubMed  Google Scholar 

  5. Goodman WG, London G, Amann K, Block GA, Giachelli C, Hruska KA, Ketteler M, Levin A, Massy Z, McCarron DA, Raggi P, Shanahan CM, Yorioka N, Vascular Calcification Work G (2004) Vascular calcification in chronic kidney disease. Am J Kidney Dis 43:572–579

    Article  PubMed  Google Scholar 

  6. Hunt JL, Fairman R, Mitchell ME, Carpenter JP, Golden M, Khalapyan T, Wolfe M, Neschis D, Milner R, Scoll B, Cusack A, Mohler ER 3rd (2002) Bone formation in carotid plaques: a clinicopathological study. Stroke 33:1214–1219

    Article  PubMed  Google Scholar 

  7. London GM, Marchais SJ, Guerin AP, Metivier F (2005) Arteriosclerosis, vascular calcifications and cardiovascular disease in uremia. Curr Opin Nephrol Hypertens 14:525–531

    Article  CAS  PubMed  Google Scholar 

  8. McCullough PA, Agrawal V, Danielewicz E, Abela GS (2008) Accelerated atherosclerotic calcification and Monckeberg’s sclerosis: a continuum of advanced vascular pathology in chronic kidney disease. Clin J Am Soc Nephrol 3:1585–1598

    Article  CAS  PubMed  Google Scholar 

  9. Niwa Y, Katano H, Yamada K (2004) Calcification in carotid atheromatous plaque: delineation by 3D-CT angiography, compared with pathological findings. Neurol Res 26:778–784

    Article  PubMed  Google Scholar 

  10. Uwatoko T, Toyoda K, Inoue T, Yasumori K, Hirai Y, Makihara N, Fujimoto S, Ibayashi S, Iida M, Okada Y (2007) Carotid artery calcification on multislice detector-row computed tomography. Cerebrovasc Dis 24:20–26

    Article  PubMed  Google Scholar 

  11. Wu M, Rementer C, Giachelli CM (2013) Vascular calcification: an update on mechanisms and challenges in treatment. Calcif Tissue Int 93:365–373

    Article  CAS  PubMed  Google Scholar 

  12. Moe SM, Chen NX (2008) Mechanisms of vascular calcification in chronic kidney disease. J Am Soc Nephrol 19:213–216

    Article  CAS  PubMed  Google Scholar 

  13. Bazan HA, Pradhan S, Mojibian H, Kyriakides T, Dardik A (2007) Increased aortic arch calcification in patients older than 75 years: implications for carotid artery stenting in elderly patients. J Vasc Surg 46:841–845

    Article  PubMed  Google Scholar 

  14. Bild DE, Folsom AR, Lowe LP, Sidney S, Kiefe C, Westfall AO, Zheng ZJ, Rumberger J (2001) Prevalence and correlates of coronary calcification in black and white young adults: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Arterioscler Thromb Vasc Biol 21:852–857

    Article  CAS  PubMed  Google Scholar 

  15. Hirooka N, Kadowaki T, Sekikawa A, Ueshima H, Choo J, Miura K, Okamura T, Fujiyoshi A, Kadowaki S, Kadota A, Nakamura Y, Maegawa H, Kashiwagi A, Masaki K, Sutton-Tyrrell K, Kuller LH, Curb JD, Shin C (2012) Influence of cigarette smoking on coronary artery and aortic calcium among random samples from populations of middle-aged Japanese and Korean men. J Epidemiol Community Health 67:119–124

    Article  PubMed Central  PubMed  Google Scholar 

  16. Iribarren C, Sidney S, Sternfeld B, Browner WS (2000) Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA 283:2810–2815

    Article  CAS  PubMed  Google Scholar 

  17. Kimoto E, Shoji T, Shinohara K, Hatsuda S, Mori K, Fukumoto S, Koyama H, Emoto M, Okuno Y, Nishizawa Y (2006) Regional arterial stiffness in patients with type 2 diabetes and chronic kidney disease. J Am Soc Nephrol 17:2245–2252

    Article  PubMed  Google Scholar 

  18. Li CI, Kardia SL, Liu CS, Lin WY, Lin CH, Lee YD, Sung FC, Li TC, Lin CC (2011) Metabolic syndrome is associated with change in subclinical arterial stiffness: a community-based Taichung community health study. BMC Public Health 11:808

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Liang J, Zhou N, Teng F, Zou C, Xue Y, Yang M, Song H, Qi L (2012) Hemoglobin A1c levels and aortic arterial stiffness: The cardiometabolic risk in Chinese (CRC) study. PLoS One 7:e38485

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Lilitkarntakul P, Dhaun N, Melville V, Kerr D, Webb DJ, Goddard J (2012) Risk factors for metabolic syndrome independently predict arterial stiffness and endothelial dysfunction in patients with chronic kidney disease and minimal comorbidity. Diabetes Care 35:1774–1780

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Pohle K, Maffert R, Ropers D, Moshage W, Stilianakis N, Daniel WG, Achenbach S (2001) Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors. Circulation 104:1927–1932

    Article  CAS  PubMed  Google Scholar 

  22. Shoji T, Emoto M, Shinohara K, Kakiya R, Tsujimoto Y, Kishimoto H, Ishimura E, Tabata T, Nishizawa Y (2001) Diabetes mellitus, aortic stiffness, and cardiovascular mortality in end-stage renal disease. J Am Soc Nephrol 12:2117–2124

    CAS  PubMed  Google Scholar 

  23. Yamada S, Hashimoto K, Ogata H, Watanabe Y, Oshima M, Miyake H (2014) Calcification at orifices of aortic arch branches is a reliable and significant marker of stenosis at carotid bifurcation and intracranial arteries. Eur J Radiol 83:384–390

    Article  PubMed  Google Scholar 

  24. Yamada S, Oshima M, Watanabe Y, Ogata H, Hashimoto K, Miyake H (2014) Intramural location and size of arterial calcification are associated with stenosis at carotid bifurcation. Eur J Radiol 83:957–963

    Article  PubMed  Google Scholar 

  25. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease study group. Ann Intern Med 130:461–470

    CAS  PubMed  Google Scholar 

  26. Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL, Bertoni AG, Budoff MJ, O’Brien KD (2006) Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis. Circulation 113:2113–2119

    Article  PubMed  Google Scholar 

  27. Sutandar W (2008) Vascular calcification of the aortic arch and peripheral artery in haemodialysis patients with and without diabetes mellitus. Acta Med Indones 40:181–186

    PubMed  Google Scholar 

  28. Wong ND, Sciammarella M, Arad Y, Miranda-Peats R, Polk D, Hachamovich R, Friedman J, Hayes S, Daniell A, Berman DS (2003) Relation of thoracic aortic and aortic valve calcium to coronary artery calcium and risk assessment. Am J Cardiol 92:951–955

    Article  CAS  PubMed  Google Scholar 

  29. Bakris GL, Williams M, Dworkin L, Elliott WJ, Epstein M, Toto R, Tuttle K, Douglas J, Hsueh W, Sowers J (2000) Preserving renal function in adults with hypertension and diabetes: a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis 36:646–661

    Article  CAS  PubMed  Google Scholar 

  30. London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H (2003) Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 18:1731–1740

    Article  PubMed  Google Scholar 

  31. Shanahan CM, Crouthamel MH, Kapustin A, Giachelli CM (2011) Arterial calcification in chronic kidney disease: key roles for calcium and phosphate. Circ Res 109:697–711

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank the radiology staff of the Hamamatsu Rousai Hospital. This work was supported by the research fund intended to promote the hospital functions of the Japan Labour Health and Welfare Organization.

Human and Animal Rights and Informed Consent

The study design and protocol were approved by the Institutional Ethical Committee. All patients were confirmed to have the appropriate indications for the MDCTA and signed an informed consent form before the MDCTA.

Author information

Authors and Affiliations

  1. Department of Neurosurgery & Stroke Center, Rakuwakai Otowa Hospital, Otowachinji-cho 2, Yamashina-ku, Kyoto, 607-8602, Japan

    Shigeki Yamada

  2. Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8505, Japan

    Shigeki Yamada & Marie Oshima

  3. Department of Neurosurgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, Higashi-ku, Hamamatsu city, Shizuoka, 430-8525, Japan

    Yoshihiko Watanabe & Hidenori Miyake

Authors
  1. Shigeki Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marie Oshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshihiko Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hidenori Miyake
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shigeki Yamada.

Additional information

Conflict of Interest

Dr. Yamada and all coauthors declare no disclosures or conflicts of interest. This research was supported by research grants intended to promote the hospital functions of the Japan Labor Health and Welfare Organization. None of the authors received royalties or financial support for this work. All authors take responsibility for data management, accuracy of statistical analysis, conduct of the research, and drafting of the manuscript. All the authors have made substantial contributions to the intellectual content of the paper, have approved the final manuscript, and agree with submission to this journal and full contact details from the journal office.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 52 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamada, S., Oshima, M., Watanabe, Y. et al. Arterial Location-Specific Calcification at the Carotid Artery and Aortic Arch for Chronic Kidney Disease, Diabetes Mellitus, Hypertension, and Dyslipidemia. Calcif Tissue Int 95, 267–274 (2014). https://doi.org/10.1007/s00223-014-9891-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00223-014-9891-2

Keywords

Search

Navigation