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

Am J Kidney Dis 2010, Jan;S5(1):21-30

Study hypothesis:

Chronic kidney disease (CKD) is associated risk of coronary heart disease.  Information regarding histopathologic characteristics of coronary atherosclerosis in CKD is scarce.  This study investigated the relationship between CKD and severity of coronary atherosclerosis in population-based autopsy samples.

Study design and study population:

Cross sectional study involving 126 individuals randomly selected from 844 consecutive population-based autopsy samples. Estimated glomerular filtration rate (eGFR) calculated using the 6 variable MDRD equation.


Severity of atherosclerosis in 3 main coronary arteries, stenosis rates and coronary calcified lesions.


Frequencies of advanced atherosclerotic lesions increased gradually as eGFR decreased.  Frequencies of calcified lesions of coronary arteries also increased gradually with lower eGFRs.  Hypertension and diabetes were associated with increased risk of advanced coronary atherosclerosis and calcification of coronary arteries in individuals with decreased eGFR.


Methodological assessment:

Cross-sectional study, absence of data for proteinuria and extremely high proportion of aged people.


The autopsy findings presented here suggest that CKD is associated significantly with severity of coronary atherosclerosis.  Patients with CKD should be considered a high-risk population for advanced coronary atherosclerosis.

- Reviewed by Dr. Paul Barré

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