Association of Kidney Function With Coronary Atherosclerosis and Calcification in Autopsy Samples From Japanese Elders: The Hisayama Study

Background Chronic kidney disease (CKD) is associated with increased risk of coronary heart disease. However, information regarding the histopathologic characteristics of coronary atherosclerosis in individuals with CKD is scarce. This study investigated the relationship between CKD and severity of coronary atherosclerosis in population-based autopsy samples. Study Design Cross-sectional study. Setting & Participants 126 individuals randomly selected from 844 consecutive population-based autopsy samples. Predictor Estimated glomerular filtration rate (eGFR) calculated using the 6-variable Modification of Diet in Renal Disease (MDRD) Study equation. Outcomes Severity of atherosclerosis in 3 main coronary arteries, including atherosclerotic lesion types defined using the American Heart Association classification; stenosis rates; and coronary calcified lesions. Measurements The relationship between CKD and severity of coronary atherosclerosis was evaluated using generalized estimating equation methods. Results Frequencies of advanced atherosclerotic lesions increased gradually as eGFR decreased (33.6%, 41.7%, 52.3%, and 52.8% for eGFRs ≥60, 45-59, 30-44, and