ArticleAtherosclerosis2023
Kidney function, bone-mineral metabolism markers, and calcification of coronary arteries, aorta, and cardiac valves in older adults.
Article in Atherosclerosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Impact of Parathyroidectomy on Vascular Stiffness: Exploring Pulse Wave Velocity and Renal Resistive Index.The Journal of clinical endocrinology and metabolism · 2026Article
- Progression of coronary artery calcification in chronic kidney disease: nonlinear associations with serum magnesium and parathyroid hormone.Frontiers in medicine · 2026Article
- Association of ankle-brachial Index with coronary and extra-coronary calcification in older adults: ARIC study.European heart journal open · 2025Article
- Serum Sodium, Potassium, Magnesium, Calcium, and Phosphorus Levels and Risk of Fracture in the Community.The Journal of clinical endocrinology and metabolism · 2025Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsThe contribution of kidney dysfunction, especially at mild-to-moderate stages, and bone-mineral metabolism (BMM) markers to vascular calcification remains controversial or unclear. We comprehensively evaluated the association of kidney and BMM markers with coronary artery calcification (CAC) and extra-coronary calcification (ECC).
methodsIn 1931 ARIC participants (age 73-95 years) without coronary heart disease at visit 7 (2018-19), we investigated the associations of estimated glomerular filtration rate (eGFR) (with creatinine, cystatin C, and both) and five serum BMM markers (calcium, fibroblast growth factor 23, magnesium, parathyroid hormone, and phosphorus) with high CAC and ECC (sex-race specific ≥75th vs. <75th percentile Agatston score) or any vs. zero CAC and ECC using multivariable logistic regression. For eGFR and BMM markers, we took their weighted cumulative averages from visit 1 (1987-89) to visit 5 (2011-13).
resultsLower eGFR, regardless of equations used, was not robustly associated with high CAC or ECC. Among BMM markers, only higher phosphorus levels, even within the normal range, showed robust associations with high CAC (only when modeled continuously) and ECC, independently of kidney function (e.g., odds ratio 1.94 [95%CI 1.38-2.73] for high aortic valve calcification, in the highest vs. lowest quartile). Results were generally consistent when analyzing any CAC or ECC, although cystatin C-based eGFR <60 mL/min/1.73 m
conclusionsAmong kidney and BMM measures tested, only serum phosphorus demonstrated robust associations with both CAC and ECC, supporting a key role of phosphorus in the pathophysiology of vascular calcification.
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Registered trials
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